Hepatitis B | Symptoms & Causes
What are the symptoms of hepatitis B?
The majority of children with acute hepatitis B have no symptoms. Parents typically have no idea their child is infected. Over time, as the virus causes increasing damage to the liver, the following symptoms may appear:
- fatigue
- nausea
- dark urine
- muscle soreness
- vomiting
- loss of appetite
- stomach pain
- jaundice
What causes hepatitis B?
Hepatitis B is caused by the hepatitis B virus (HBV). The virus is passed from person to person through contact with blood infected with HBV, sexual intercourse, or intravenous drug use. Mothers infected with HBV can pass the virus on to their children during childbirth, though doctors can reduce that risk by giving newborns both the hepatitis B vaccine and a medication called hepatitis B immune globulin (or HBIG) within about 12 hours of birth.
While the number of new cases of hepatitis B in the United States has dropped dramatically in the last two decades — thanks to the vaccination — the Centers for Disease Control and Prevention estimates between 885,000 and 2.2 million people in the U.S. have chronic HBV infection.
Hepatitis B | Diagnosis & Treatments
How is hepatitis B diagnosed?
A doctor who suspects that a child is infected with HBV may test the child’s blood to see if it contains a portion of the virus called the surface antigen. If the test comes back positive, the doctor may run additional tests for the other portions of the virus that can provide more information.
Children and adults with HBV surface antigen in their blood for more than six months typically undergo periodic tests to monitor their liver function and look for signs of serious liver disease. If such tests show that the virus is starting to damage the child’s liver, doctors may order a biopsy to determine if it is appropriate to start treatment.
The doctor will likely ask about family history of liver disease, in particular liver cancer. Knowing the family’s health history can help predict how the virus will affect the child.
How is hepatitis B treated?
Doctors treat acute and chronic hepatitis B very differently. In prescribing treatment for hepatitis B, doctors aim to disable the virus, reduce the amount of virus in the blood, and prevent liver damage that could lead to cirrhosis or liver cancer.
If a child has acute hepatitis B, doctors will recommend rest, healthy eating, and drinking plenty of fluids. If the infection has lasted more than six months and doctors see signs of liver damage, they may recommend starting treatment with one of a variety of medications.
Should a child with hepatitis B get the hepatitis vaccine?
While the hepatitis B vaccine is not effective in anyone already infected with the virus, any child or adult with hepatitis B should receive the vaccine against hepatitis A in order to prevent additional liver inflammation and injury. There is currently no vaccine for hepatitis C.
What is the long-term impact of chronic hepatitis B?
Children with chronic hepatitis B can lead completely normal lives, attend school, and play sports without any special arrangements, just like any other child.
A child with chronic HBV infection could be infected for life. Over the decades, the virus can cause progressive damage to the liver and lead to such complications as cirrhosis and liver cancer.
When they become older, children with hepatitis B should avoid drinking alcohol, as it can make the disease progress more quickly. Once they become sexually active, they should practice safe sex to protect their partners from infection.
Hepatitis B | Research & Innovation
Our areas of innovation for hepatitis B
Liver biopsies provide a great deal of information about the extent of damage in a child’s liver, but the procedure is invasive and can be both painful and risky. Researchers at Boston Children’s are investigating an ultrasound-based imaging technology called FibroScan™ that may be able to help doctors assess liver scarring without the need for a biopsy.
