Digestive and Gastrointestinal Conditions

Viral Hepatitis

What is viral hepatitis?

Viral hepatitis is an infection from a virus that causes inflammation of the liver. In the United States, there are 3 common types of viral hepatitis: A, B and C.

  • Hepatitis A is a short-term (acute) disease that causes the liver to become inflamed and not work properly.

    Unlike hepatitis B or C, hepatitis A is an illness that you usually get for a short period of time (months) and then get better. However, hepatitis A is contagious and easily passed to other people through poor hand hygiene.

    Hepatitis A is spread through food contaminated with feces (stool) from an infected person. This is less common in the United States than it is in some other countries.

    We strongly advise that children ages 1 year and older who are traveling to high-risk countries outside the United States get the hepatitis A vaccine. All children over age 2 are recommended to be vaccinated against hepatitis here in the United States.

    Hepatitis A does not need to be treated with a specific medicine. Most people get better and do not have permanent liver damage.

  • Hepatitis B and C are contagious liver diseases that can either be acute (causing short-term illness) or chronic (causing long-term illness).

    Acute hepatitis B and C occur shortly after someone is exposed to the virus. They can lead to chronic infection. Chronic hepatitis B and C is when the virus remains in the person’s body for longer than 6 months after they were first exposed.

    Children may also get hepatitis B or C because they are living with or have exchanged blood and/or bodily fluids with someone who is infected.

    Hepatitis B and C can also be spread by:

    • Having unprotected sex with an infected person, especially when there is potential for bleeding.
    • Sharing contaminated needles or other drug-injecting equipment.
    • Having a blood transfusion in a country where blood is not screened for viral hepatitis. (The United States began widespread screening of its blood supply in 1992. Today, some adults with hepatitis C became infected through a blood transfusion or organ transplant before 1992.)

    Chronic hepatitis B and C may require treatment with medicines.

    If left untreated over a long time, hepatitis B and C can cause liver damage, such as cirrhosis or liver cancer.

  • Viral hepatitis is spread in different ways depending on the type. Hepatitis B and C are the types that lead to persistent and chronic infection. The most common way children are infected is when a mother with hepatitis B or C passes the virus to the baby during birth.

  • Hepatitis A is spread through feces, such as when someone does not wash their hands well after having a bowel movement and then infection is passed via food. Although not as common in the United States as in other parts of the world, hepatitis A is most commonly spread through contaminated food.

    Hepatitis B and C are blood infections and spread when the blood or other bodily fluids (semen and/or vaginal fluids) of an infected person enter the bloodstream of a noninfected person. In children, the most common way that hepatitis B and C are spread is when a mother with the condition passes the virus to the baby during delivery with exposure to blood and fluids during the birth process.

  • In most cases, viral hepatitis can be prevented.

    • Preventing hepatitis A. The best way to prevent spreading hepatitis A is to wash your hands thoroughly and frequently with soap and water, especially prior to handling food. If traveling to countries outside the United States, having the hepatitis A vaccination is strongly recommended.
    • Preventing hepatitis B. The vast majority (approximately 90% to 95%) of hepatitis B cases can be avoided by receiving the hepatitis B vaccine. The Centers for Disease Control (CDC) recommends that your child get 3 doses of the hepatitis B vaccine starting at birth.
    • Preventing hepatitis C. The best way to prevent hepatitis C is to avoid exposure to the blood or bodily fluids (breast milk, saliva, semen or vaginal fluids) of an infected person. There is currently no hepatitis C vaccine available, although 1 is in clinical trials.

Viral Hepatitis at Seattle Children’s

  • Seattle Children’s is a leader in developing and researching new treatments to return your child to health.

    When your child is treated for viral hepatitis here, they are provided access to medicines and therapies that aren’t available anywhere else. We’re able to offer the latest cutting-edge treatments that others simply cannot, thanks to our research trials.

    Seattle Children’s is the only pediatric hepatology group in Washington, Montana, Idaho and Oregon involved in leading treatment trials for advancing new medications to children with viral hepatitis, including oral medications currently only approved for use in adults. Because these newer medicines are taken by mouth, they are often better tolerated by children and have fewer side effects than the injections currently approved for use in children. Therefore, your child has an opportunity to overcome their illness quicker and more comfortably.

  • Our doctors are some of the top experts in diagnosing and treating viral hepatitis in children. In fact, U.S. News & World Report ranked Seattle Children’s Gastroenterology Program best in the Pacific Northwest and among the best in the country in 2016. Our team of pediatric hepatologists (liver experts), surgeons, nurses and research trial coordinators partner together to provide the most advanced care to your child and offer the support and guidance your family needs.

  • Our team of doctors and nurses are trained to treat children of all ages, from newborns to teenagers. We work together for the common goal of returning your child to health. We understand our young patients have unique needs, and our specially trained clinicians will work with your child and family to ensure all of your questions are answered using language and hands-on demonstrations they can understand.

  • We respect the emotional toll your child’s illness can have on you and your family. That’s why our team includes psychologists and social workers who will help your child understand their disease in language your child can understand and provide the support your child and family need.

  • Seattle Children’s is part of the Hepatitis B Research Network (HBRN). This is a group of 7 pediatric centers around North America collecting data to learn more about hepatitis B and using innovative therapies to treat this persistent infection.

    We are also investigating the effects of hepatitis B and C on the liver in children, trying to understand what effect the virus has on your child’s quality of life — and that of your family.

    If your child meets the criteria for our research trials and is accepted into our program, our research coordinators will work with your child and family through every step of the treatment process.

Symptoms of Viral Hepatitis

Just like adults, most children with viral hepatitis will typically not have symptoms. If they do, it is likely the liver disease has already advanced.

If your child has acute hepatitis (hepatitis A), they may have the following symptoms:

  • Yellow color in the skin or eyes (jaundice)
  • Dark urine
  • Fever
  • Stomach pain
  • Feeling tired (fatigue)

Most people with chronic hepatitis B and C do not have symptoms. Adults may feel tired, but it is very uncommon for children with chronic hepatitis B or C to have symptoms.

Diagnosing Viral Hepatitis

Because people with viral hepatitis often do not have symptoms, your child’s doctor may use more than 1 way to make an accurate diagnosis.

To determine if your child has viral hepatitis, your Seattle Children’s doctor will:

  1. Ask you and your child questions: The doctor will ask you and your child questions about your child’s past health, any symptoms, your family’s health and your child’s contact with people infected with viral hepatitis.
  2. Do blood tests: If the doctor thinks your child may have viral hepatitis, they will order a blood test to check the liver enzymes, called aminotransferases. Higher-than-normal liver enzyme levels may indicate that your child has viral hepatitis. Your child’s doctor may also test to see if there are viral antibodies in your child’s blood, which may mean the body is fighting against a viral infection such as viral hepatitis.
  3. Perform a liver biopsy: Your child’s doctor may take a small sample of your child’s liver tissue (biopsy) to learn information that will help guide treatment. The team at Seattle Children’s performs liver biopsies on children under anesthesia.

Treating Viral Hepatitis

Viral hepatitis is treated in different ways depending on whether your child has hepatitis A, B or C.

  • Hepatitis A is a short-term virus typically lasting several weeks to months. For most children, hepatitis A goes away on its own and does not require treatment. Your child’s doctor may encourage your child to rest, drink plenty of liquids and eat healthy foods.

    Once your child has had hepatitis A, they are usually immune to the illness and cannot get it again. However, your child could still get other forms of viral hepatitis, such as hepatitis B and C.

  • If your child has chronic hepatitis B or C, they may need to be treated with antiviral medicines. Your child’s doctor and care providers will perform tests to learn if your child should be treated. Seattle Children’s offers treatments and therapies not offered elsewhere.

    Depending on the type of viral hepatitis your child has, their doctor will tell you if your child needs follow-up care after treatment is finished.

Contact Us

Contact the Seattle Children’s Gastroenterology and Hepatology Department at 206-987-2521 for a referral, a second opinion or more information.