Hepatitis C in infants, children and teens

You might think that hepatitis C only occurs in adults, but children also suffer from liver disease. Most children get it in infancy, but teens who inject street drugs or have unprotected sex can also become infected. Your child's doctor may suggest treatments to control or even cure the condition.

When your child has hepatitis C

If you are pregnant and have hepatitis C, you can pass the virus that causes the disease to your baby during childbirth, whether you give birth vaginally or by caesarean section.

There are tests available when your baby is 3 months old, but many experts do not recommend them because babies cannot be treated until they are older.

Signs that your child has hepatitis C:

Dark, brownish pee
Pale, clay-colored bowel movements
Stomach pain, vomiting, or diarrhea
Jaundice (yellowish skin and eyes)
Fever
Tiredness
Bruising
Swelling in the legs

Your child may also have an enlarged liver or spleen. Your doctor will be able to check this with a physical exam or with imaging tests.

Your doctor may suggest that your child have blood tests to diagnose hepatitis C. These are the same tests used on adults, but they are only done on children older than 2 years.

Anti-HCV test. It looks for specific protein antibodies in your baby's blood. However, it is not reliable because it does not show if the hepatitis C virus is active.
HCV RNA test or HCV qualitative test. This allows you to determine if active hepatitis C virus is present in your child's blood.
Quantitative HCV test or viral load test. It checks the amount of virus in the blood. You will receive results measured in international units per litre. Smaller numbers mean the disease is easier to control.
Viral genotyping. This test shows which type of hepatitis C, called the "genotype", is causing your child's infection.

Rarely, your child's doctor may order an ultrasound to check for liver cancer.

Keep in mind that HCV symptoms take time to show up, and 80% of people with the disease have no symptoms. Indeed, they can do without signs of illness for years.

Hepatitis C in children under 12 years of age

Hepatitis C resolves without treatment in 40% of cases before the age of two years. The virus disappeared in some children at the age of 7 years.

If your child still has hepatitis C after age 2, you may hear your doctor refer to it as a "chronic" infection. For the most part, the disease causes minor liver problems. About 25% of children have a higher risk of scarring of the liver, called cirrhosis. In most cases, this only happens when the child becomes an adult.

If your child needs treatment, the doctor may suggest the following medicines:

Interferon and ribavirin. Studies show that in 50-90% of cases this will lead to the cessation of hepatitis C infection. It is the only approved treatment for children under 12 years of age. Your child may have side effects such as fatigue, fever, chills, and depression.

Your doctor will likely recommend that your child get the hepatitis A and hepatitis B shots, as well as the regular flu shot. Ask your doctor about medications to avoid as they can damage the liver, such as acetaminophen.

Also, make sure your child eats a healthy diet. Make sure he eats regular, well-balanced meals, eats plenty of fruits and vegetables, likes whole grains and protein-rich foods, and avoids salt.

Most children with hepatitis C lead active, normal lives, including sports and social activities. The disease cannot be transmitted through casual contact. But because the virus can be transmitted to others through blood and bodily fluids, your child should not share personal items, such as toothbrushes and nail clippers, with other children. And make sure he or she covers injuries like cuts and scrapes.

Teens with hepatitis C

If your child was not born with hepatitis C but contracted it during adolescence, it is likely due to the use of dirty needles when injecting illicit drugs, unprotected sex, or exposure to contaminated blood.

Untreated teens with hepatitis C can develop cirrhosis of the liver. Although adults have a large selection of antivirals, for children 12 to 17 years of age, two:

Sofosbuvir. This medicine, as for the adults who take it, cures the disease in most cases. The most common side effects are fatigue and headaches.
Ledipasvir-sofosbuvir. It is a combined antiviral drug that destroys the virus in 95% of children who take it. Your child may experience side effects such as diarrhea, feeling tired, or trouble sleeping.