Hepatitis C is an infectious blood-borne virus that attacks the liver. In the United States, there are more than 4 million people who have ever had hepatitis C virus infection; approximately 250,000 of those are children.
The hepatitis C virus is transmitted by exposure to blood and body fluids of an infected person. However, the most frequent source of transmission is direct exposure to infected blood.
Risk factors for contracting the virus include:
The virus can also be transmitted during the perinatal period if an infant is born to a mother who has hepatitis C virus.
Hepatitis C is not transmitted by kissing, hugging, sneezing, coughing, food or water, or casual contact. Children infected with hepatitis C virus should not be excluded from school, play or any other childhood activity based on their infection status.
Currently, there is no vaccine available to prevent the transmission of hepatitis C virus from person to person. In order to protect your child make sure your child does not have direct contact with infected blood. This means your child should not share items such as needles, razors, or toothbrushes since they may have had another person's blood on them.
From the time a person contracts the virus it takes, on average, two weeks for the virus to be detected in the blood. However, the average incubation period, from the time you contract the virus to when symptoms may present, is six to nine weeks.
Symptoms of a hepatitis C virus infection can include:
Not everyone who has hepatitis C will experience symptoms.
Hepatitis C virus can produce both acute and chronic infections. A recent infection with the hepatitis C virus is called an acute infection. Often, a person with an acute hepatitis C infection will not have any symptoms.
A hepatitis C infection that persists for more than six months after diagnosis of an acute hepatitis C infection is generally considered to be a chronic infection. Most people who contract the hepatitis C virus will develop a chronic infection, and many of these people will experience chronic liver disease. Complications from chronic hepatitis C infection can lead to liver failure requiring liver transplantation. People with chronic hepatitis C virus infection should remember that drinking alcohol will make their liver disease worse.
Although an infant born to a mother with hepatitis C virus infection may have signs of active infection at birth it is possible for infants to clear the infection on their own without any medicines. If the infant is able to clear the virus from their body this usually occurs within the first two years of life. If after age 2 a child still shows sign of active infection, it is less likely he or she will clear the virus from their blood on their own.
It is recommended that people who fall into one or more of the following risk categories be tested to see if they have the hepatitis C infection:
There are a number of blood tests your child's doctor may order to check whether your child has hepatitis C, or — if your child has the infection — to check the status of the infection:
There may be certain circumstances when your child's doctor will order a liver biopsy in order to check on the progression of your child's infection.
There are six major identified hepatitis C virus genotypes, that is, specific genetic sequencing of the virus. In the United States, genotypes 1, 2 and 3 are most common, with genotype 1 accounting for the majority of cases.
Your child's genotype is important because certain genotypes respond better to treatment than others and the treatment regimen is different depending on the genotype. Your child's doctor will test to see which genotype your child has before starting therapy for your child's infection.
Antiviral treatments are available for people with chronic hepatitis C infection. Treatment can last for several months up to a year. When successful, treatment is considered curative.
The first two U.S.-approved treatments for children with chronic hepatitis C are interferon and ribavirin. Many new therapies are in development and are marketed. Your child's treatment is tailored to the specific genotype of the virus he or she has. The field of treatment is rapidly changing. The best and most current treatment information should be obtained directly from your child's hepatologist (liver specialist).
The Viral Hepatitis Clinical Care Program participates in a number of treatment trials for children with chronic infection involving both approved and experimental treatments. To learn more about the treatment trials offered at The Children's Hospital of Philadelphia, please call 1-866-KID-LIVR (1-866-543-5487). To learn about trials in your area, please visit www.clinicaltrials.gov.
Reviewed by: Jessica Wen, MD
Date: December 2013