What Is Hepatitis C?
Hepatitis C is a liver disease caused by the hepatitis C virus, which is carried in the blood of infected people. According to various estimates, there are anywhere from approximately 3 to 10 million people in the United States who are carriers of the virus. One reason for the uncertainty is that the virus wasn't even diagnosed until the late 1980s. In fact, a majority of hepatitis C virus carriers are still unaware that they have it.
As compared to adults, knowledge of hepatitis C virus infection in children is limited. This is because far fewer children are infected with hepatitis C virus, and children are less likely to have symptoms from their hepatitis C virus infection. Clinical liver disease due to hepatitis C virus is extremely rare in childhood. The exceptions are mainly children with other risk factors (other viruses, chemotherapy, immunosuppression).
The disease is serious for some people, but not for others. Most people who get hepatitis C carry the virus for the rest of their lives. The majority will experience some liver damage, but may not feel sick from the disease. Some people with liver damage due to hepatitis C may develop cirrhosis (scarring) of the liver and liver failure, which may take many years to develop.
Hepatitis C is primarily spread through contact with infected blood. The virus can be passed on by injecting drugs with shared needles; receiving a tattoo, body piercing, or acupuncture with unsterilized equipment; or less commonly through sexual contact. Children are more likely to contract hepatitis C virus through:
- Being born to a mother who is infected with hepatitis C virus
- Receiving hepatitis C virus-infected blood transfusions (before 1992) or blood clotting products (before 1987)
- Receiving an hepatitis C virus-infected organ transplant
- Receiving long-term kidney dialysis treatment (dialysis machine can be tainted with hepatitis C virus-infected blood)
- Sharing personal hygiene items (such as toothbrushes, razors, or nail-clippers) that have hepatitis C virus-infected blood on them
It is important to remember that the hepatitis C virus can not spread through:
- The air
- Unbroken skin
- Casual social contact
- Breast-feeding
Hepatitis C Symptoms in Infants and Children
Although the hepatitis C virus can be detected in blood between one to three weeks after the initial exposure, 80 percent of people with hepatitis C have no symptoms, and thus go undiagnosed., Most patients begin to develop liver cell injury within approximately 50 days, although they will be asymptomatic (symptom-free). In about 15 percent of people exposed to the virus, their bodies clear it out of their system naturally within six months. The remaining 85 percent of people with hepatitis C will develop some level of chronic hepatitis C. Over time, this can cause serious liver damage, although the rate of progression can vary significantly from individual to individual. Hepatitis C symptoms may include:
- Fatigue
- Loss of appetite
- Jaundice (yellowing of the eyes and skin)
- Darker colored urine
- Abdominal pain
- Aches and pains
- Itching
- Hives
- Joint pain
- Loose, light-colored stools
- Nausea
- Vomiting
Serious complications of hepatitis C infection include:
- The possibility that the infection will become chronic, leading to progressive liver failure
- Increased risk of hepatocellular carcinoma (liver cancer)
- Cirrhosis – Within about 20 years of exposure, about 20 percent of individuals develop cirrhosis, which leads to end-stage liver disease.
Hepatitis C Diagnosis
To diagnosis hepatitis C, your child's doctor will ask about symptoms, medical history, and perform a physical exam. Your doctor will also want to discuss your child's risk factors for hepatitis C. Tests that may be conducted include:
- Blood Tests – to look for hepatitis C antibodies or genetic material from the virus (The antibodies are proteins that your body has made to fight the hepatitis C virus.)
- Liver Biopsy – removal of a sample of liver tissue to be examined
Hepatitis C Treatment
Hepatitis C treatment includes medications. The most common are:
- Interferon, given by injection
- Ribavirin, given orally
- A combination of interferon and ribavirin
The course of this type of treatment is usually over a period of months. These medications can cause side effects that resemble the symptoms of hepatitis C itself, only magnified. However, these antiviral treatments can dramatically reduce the presence of the hepatitis C virus in the bloodstream. The limited studies available on the effectiveness of antiviral treatments on children show that they have an overall better response rate to this therapy than adults.
Even with treatment, hepatitis C infection may not clear up within six months. In rare cases, a liver transplant may be needed. However, it is possible that hepatitis C can affect the new liver after transplantation.
Learn about other Liver Disease States.
