PAEDIATRIC HEPATITIS B: ALL YOU NEED TO KNOW

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Hepatitis B is a disease that affects the liver that is caused by the hepatitis B virus(HBV). It spreads through blood, saliva or other bodily fluids(eg semen, vagina fluids). 

The most common way children become infected with it is if they are born to a mother with the virus, though this risk can be reduced by giving newborns both the hepatitis B vaccine and a medication called hepatitis B immune globulin(HBIG) within about 12 hours of birth.

Older children can get infected through injection drug use or unprotected sex.

There are two stages of hepatitis B: Acute and Chronic Hepatitis

Acute hepatitis B is often a mild or asymptomatic disease that may clear on its own in a matter of weeks. In younger persons, the virus is less likely to get cleared on its own, and more likely to get chronic.

Children and adults who are not able to clear the infection within six months are considered to have chronic hepatitis B.

Chronic hepatitis B is a serious illness that can cause long-term health problems. Over time, the liver may stay healthy or develop progressive scarring that leads to cirrhosis. Of all other causes, this is the most common cause of liver cancer in the world.

Over decades, chronic hepatitis B progresses through four stages;

  • Immune tolerance
  • Immune clearance
  • inactive/latent
  • reactivation

This is based on the behaviour of the virus and how the immune system of the child reacts to it. The inactive carrier stage can last for many years, often well into adulthood.


How does it affect the liver?

In acute hepatitis B, the liver can get swollen and inflamed. However, it is oftentimes silent, especially in babies but when the infection gets chronic, the virus then cause inflammation and make the healthy, soft tissues of the liver harden and scar.

Almost a quarter of persons  living with chronic hepatitis B develop serious liver diseases like cirrhosis or liver cancer.


Symptoms

The bulk of children living with acute hepatitis B all over the world has no symptoms. Parents usually do not have any idea that their child is infected. Over time, as the virus causes much damage to the liver, the following symptoms may occur:

  • Fatigue
  • Nausea
  • Dark urine and light-coloured stool
  • Muscle soreness
  • Vomiting
  • Loss of appetite
  • Stomach pain
  • Jaundice
  • Fever
  • Widespread itching
  • Rash


Treatment

Doctors treat acute and chronic hepatitis B in different ways. If a child has acute hepatitis B, your doctor will recommend rest, healthy eating, and drinking plenty of fluids.

If the infection has lasted more than 6 months and your doctor sees signs of liver damage, he/she may recommend starting treatment with one of a variety of medications such as interferon alfa-2b(Intron A) injection, lamivudine(Epivir-HBV) oral medication, etc.


The long-term impact of chronic hepatitis B

Kids who live with chronic hepatitis B, without any particular arrangements, can live their normal lives, just like any other kid.

A kid living with chronic HBV infection could be infected for a lifetime. Over the years, the virus can cause progression to the liver and lead to complications such as cirrhosis and liver cancer.

As they get older, they should avoid drinking alcohol as it can make the illness progress more quickly and once they get sexually active, they should practice safe sex to protect their partners from infection.


More Info on Vaccination

Children need to receive hepatitis B vaccination. This consists of three injections over 6 months and protection is incomplete without all three injections.

If a woman is pregnant, she should get a blood test for hepatitis B. If she is diagnosed as positive, she should make sure that her baby gets a shot called HBIG and the first dose of the hepatitis B vaccine within 12 hours of birth.

Her baby should get the second dose of the hepatitis B vaccine at 1-2 months old and the third dose at 6 months old. Her child should also run a blood test at age 9-15 months to be sure he/she is protected.

Dr. favvy


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