Hepatitis in children

Many parents hear the term hepatitis and either worry or don't understand what it means for their child. Hepatitis is an inflammation of the liver that can be caused by different diseases, including a virus. Hepatitis A, hepatitis B and hepatitis C are the most common viruses causing hepatitis.

Despite similar names, each of these viruses is different and often requires different preventive measures to keep children (and adults) healthy.

Norberto Rodriguez-Báez, M.D., Gastroenterologist at Children's Health℠ and Professor of Pediatrics at UT Southwestern, is an expert on hepatitis, conducting research and seeing patients at Children's Medical Center Dallas. He shares his insights on hepatitis A, B and C, and how parents can help reduce their child's risk of contracting what can turn into a serious illness.

What is hepatitis A?

"Hepatitis A is a highly contagious virus that leads to serious complications," says Dr. Rodriguez-Báez. "Because hepatitis A can spread easily, it's critical that parents protect their children against this preventable infection."

Hepatitis A is most often a food or water-borne illness. It can be spread by:

• Eating food prepared by someone with hepatitis A who did not properly wash his or her hands

• Water contaminated with the feces of someone with hepatitis A

• Touching an area contaminated by feces

• Sexual contact with someone infected with hepatitis A

• Sharing needles or syringes

In the United States, hepatitis A rates have declined dramatically since the hepatitis A vaccine became available in 1995 and routine childhood vaccination was implemented, resulting in more than a 95% reduction compared with the pre-vaccine era. Despite this progress, the Centers for Disease Control and Prevention (CDC) estimates that several thousand infections still occur each year.

Young children, particularly those under age 6, often have mild or no symptoms when infected, which can make hepatitis A difficult to detect. Because asymptomatic children can still spread the virus, parents should contact a pediatrician if they believe their child has been exposed so appropriate guidance, testing or preventive measures can be considered.

The American Academy of Pediatrics (AAP) strongly recommends a two-dose hepatitis A seriesfor children aged 12 – 23 months old, and children and adolescents aged 2 to 18 years old who have not previously received it.

What is hepatitis B?

Hepatitis B is a chronic liver infection that spreads through infected blood, semen and other bodily fluids. The hepatitis B virus can be transmitted:

• During birth when the mother is infected with the virus

• Through sexual contact with an infected individual

• By sharing contaminated needles, syringes and drug paraphernalia

• By sharing needles for tattoos and piercings

An estimated 14,400 acute hepatitis B infections occurred in the United States in 2023. Some individuals with hepatitis B recover without lasting liver damage. However, it poses serious long-term health risks to individuals that remain infected. Roughly 15 to 25% of chronic hepatitis B cases will progress to a liver disease such as cirrhosis, liver failure or liver cancer.

Parents can help protect their children by making sure they receive the full series of the hepatitis B vaccine. The AAP strongly recommends a three-dose hepatitis B vaccine series starting with a birth dose within 24 hours for all newborns, regardless of maternal hepatitis B status, and additional shots given between 6 and 18 months of age, depending on the type of vaccine used.

Hepatitis B vaccine remains a safe, effective tool for preventing serious liver disease.

Your child’s pediatrician can help you understand the recommended schedule and what’s best for your child’s health.

What is hepatitis C?

Hepatitis C is a type of viral hepatitis that is more common in adults than in children. In 2023, there were an estimated 69,000 new cases of acute hepatitis C in the U.S.

Hepatitis C also poses serious long-term health risks. Approximately 75 to 85% of individuals with acute hepatitis will develop chronic hepatitis, which often leads to severe liver disease.

Hepatitis C is transmitted by:

• Sharing contaminated needles, syringes or other drug paraphernalia used for injections

• Sexual contact with an infected partner

• An infected mother during childbirth

• Injury from a needle stick or other sharp instrument

• Sharing contaminated needles for tattoos or piercings

There is no vaccine for hepatitis C, so it's important for parents to educate their children on the risks of drug use, sharing needles and unprotected sex. However, if someone becomes infected, modern medicines called direct-acting antivirals can usually cure it. Staying informed and aware of treatment options is important for your family’s health.

What is the difference between hepatitis A, B and C?

It can be hard to understand the difference between hepatitis A, B and C because they all affect the liver. The main differences come down to how the viruses spread and whether they can cause long-term infection.

Hepatitis A usually causes a short-term illness and spreads through contaminated food or close contact. Hepatitis B spreads through blood and body fluids, including from a birthing parent to a baby at birth, and can become chronic. Hepatitis C is spread through contact with infected blood and is often a long-term infection.

Vaccines can prevent hepatitis A and B, and hepatitis C can often be cured with medication.

What are the symptoms of hepatitis?

Hepatitis A, B and C have similar symptoms, which include:

• Fatigue

• Fever

• Gray-colored bowel movements

• Jaundice

• Joint pain

• Loss of appetite

• Nausea

• Vomiting

"Occasionally, there are no symptoms of hepatitis. Children under age 6 may have no symptoms," says Dr. Rodriguez-Báez. "If you suspect you or your child has been in contact with someone infected with hepatitis A, B or C, it's important to contact your pediatrician right away for testing and treatment."

How can I protect my child?

“One of the most effective ways parents can safeguard their children against hepatitis A and B is through timely vaccination,” says Dr. Rodríguez-Báez. “Vaccines provide a proven and reliable layer of protection against these viruses. In addition, having age-appropriate conversations about behaviors that increase the risk of hepatitis – such as drug use, sharing needles and unprotected sex – can further support a child’s long-term health.”

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The Pediatric Liver Disease Program is at the forefront of research into new treatments for acute liver failure, viral hepatitis and other chronic liver diseases. We're helping set the standard for the diagnosis and treatment of liver diseases in children. Learn more about our program and services.