Hepatitis C

The liver is one of the organs that helps with digestion but is not part of the digestive tract. It is the largest organ in the body and carries out many important functions, such as making bile, changing food into energy, and removing toxins from the blood.

Hepatitis is a general term suggesting inflammation of the liver that in some cases can cause permanent damage. It is most commonly caused by viruses, bacteria, certain medications, irritation from fat or alcohol. It may also be caused by certain diseases, such as autoimmune diseases, metabolic diseases (Wilson disease), and congenital (present at birth) abnormalities like biliary atresia. Generally, symptoms of hepatitis include fever, jaundice and an enlarged liver. There are several types of hepatitis.

Hepatitis C (known as HCV) is a liver disease caused by a bloodborne virus. Discovered in 1989, this strain of acute viral hepatitis causes approximately 8,000 new infections in U.S. children each year. The primary mode of transmission is mother to child.

Recovery from this infection is rare--about 65% of infected people become chronic carriers of the virus. Approximately 20% of people infected with hepatitis C virus will become sick with jaundice or other symptoms of hepatitis.

Chronic liver disease due to hepatitis C causes between 8,000 and 10,000 deaths and is the leading indication for liver transplantation each year in the United States.

Patients can be seen by Texas Children's experts in Viral Hepatitis Clinic.

Causes & Risk Factors

Transmission of hepatitis C occurs primarily from contact with infected blood, but can also occur from sexual contact or from an infected mother to her baby. Blood transfusions prior to 1992 and the use of shared needles are other significant causes of the spread of hepatitis C.

People who may be at risk for contracting hepatitis C:

• Children born to mothers who are infected with the virus

• People who have a blood-clotting disorder, such as hemophilia and received clotting factors before 1987

• People who require dialysis for kidney failure

• People who received a blood transfusion before 1992

• People who may participate in high-risk activities, such as intravenous (IV) drug use and/or unprotected heterosexual or homosexual sexual contact

There is no vaccine for hepatitis C. People who are at risk should be checked regularly for hepatitis C. People who have hepatitis C should be monitored closely for signs of chronic hepatitis and liver failure.

Symptoms & Types

The following are the most common symptoms for hepatitis C, though it should be noted that most children do not present with any symptoms. Symptoms may include:

• Loss of appetite and weight loss

• Fatigue

• Nausea, vomiting, or abdominal pain

• Jaundice (yellowing of the skin and eyes)

• Fever

• Dark urine

• Muscle and joint pain

Symptoms may occur from 2 weeks to many months after exposure. The symptoms of hepatitis C may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

Diagnosis & Tests

In addition to a complete medical history and physical examination, diagnostic procedures for hepatitis C may include the following:

• Liver transaminases, HCV antibody, HCV viral load

• Liver biopsy, a procedure performed to obtain tissue information from the liver for examination under a microscope in order to determine extent of inflammation or scarring

Treatment & Care

Specific treatment for hepatitis C will be determined by your child's doctor based on:

  • Age, overall health, and medical history
  • Extent of the disease (degree of scarring)
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the disease
  • Your opinion or preference
  • Availability of clinical trials or newly approved medications

At the present time, a vaccine is not available for the prevention of hepatitis C.

Living & Managing

Whether you tell your child’s school nurse, teacher, coach, or principal is up to you.  You are not required to share your child’s Hepatitis C diagnosis, as the risk of transmission is virtually zero in the school and sports setting.

Recommended Resources

http://www.cdc.gov/hepatitis/c/

http://www.liverfoundation.org

http://www.hepatitis.va.gov

More Information

References & Sources

Story of a Child with HCV and their journey with Dr. Leung