Hepatitis

What Causes Hepatitis?

Hepatitis in children has many different origins and causes. A child may contract hepatitis from exposure to a viral source. The following is a list of some of the viruses associated with hepatitis:

• Hepatitis viruses – Six main types of the hepatitis virus have been identified, including hepatitis A, B, C, D, E and G.
• Cytomegalovirus (CMV) – A virus that is a part of the herpes virus family that can be transmitted from person to person.
• Epstein-Barr virus (EBV) – The virus most commonly associated with infectious mononucleosis.
• Herpes simplex virus (HSV) – Herpes can involve the face and skin above the waist, or the genitalia.
• Varicella zoster virus (VZV) – Also known as chickenpox, a complication of VZV is hepatitis.
• Enteroviruses – A group of viruses commonly seen in children such as coxsackieviruses, hand-foot-mouth disease and echoviruses.
• Rubella – Caused by the rubivirus, rubella is a mild disease that causes a rash.
• Adenovirus – A group of viruses that commonly cause colds, tonsillitis and ear infections in children. They can also cause diarrhea.
• Parvovirus – A virus referred to as fifth disease, which is characterized by a facial rash that is described as having a "slapped-cheek" appearance.

The following is a list of some of the diseases that may cause chronic hepatitis in children:

• Autoimmune liver disease – The body's immune system develops antibodies that attack the liver causing an inflammatory process that leads to hepatitis.
• Chronic viral hepatitis – Usually caused by hepatitis B, C, or D.

What Are the Symptoms of Hepatitis?

The following are the most common symptoms of hepatitis. However, each child may experience symptoms differently and some children may experience no symptoms at all.

Symptoms of acute (abrupt onset) hepatitis may include the following:

• Flu-like symptoms
• Fever
• Nausea and/or vomiting
• Decreased appetite
• Not feeling well all over
• Abdominal pain or discomfort
• Diarrhea
• Joint pain
• Sore muscles
• Itchy red hives on skin

Later symptoms include dark-colored urine and jaundice (yellowing of the skin and eyes). The symptoms of hepatitis may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

How Is Hepatitis Diagnosed?

In addition to a complete medical history and examination by your physician, diagnostic procedures and other tests to determine the extent of the disease may include the following:

Blood testing for the following:

• Liver function studies
• Antibody studies (to check for hepatitis)
• Cellular blood counts
• Bleeding times
• Electrolytes
• Other chemicals in the body
• Ultrasound
• Liver biopsy

How Is Hepatitis Treated?

Specific treatment for hepatitis will be determined by your child's physician based on:

• Your child's age, overall health and medical history
• Extent of the disease
• Your child's tolerance for specific medications, procedures or therapies
• Expectations for the course of the disease
• Your opinion or preference

Treatment for hepatitis varies depending on the underlying cause of the disease. The goal of treatment is to stop damage to the liver and alleviate symptoms.

Treatment may include one, or more, of the following:

• Supportive care (healthy diet and rest)
• Medications (to help control itching)
• Avoiding alcohol and drugs
• Preventing the spread of the disease (if the cause is viral hepatitis)
• Interferon drug therapy — A medication referred to as a "biologic response modifier" that can affect the immune system and has virus-fighting activities.
• Frequent blood testing (to determine disease progression)
• Hospitalization (may be required in more severe cases)
• In severe cases, liver transplantation

Preventing the Spread of Viral Hepatitis

Proper hygiene is the key to preventing the spread of many diseases, including hepatitis. Other preventative measures include:

• Vaccinations – Vaccinations are available for hepatitis A and B.
• Blood transfusion – Blood transfusions are routinely screened for hepatitis B and C to reduce the risk of infection.
• Antibody preparation – If a person has been exposed to hepatitis A or B, an antibody preparation (immunoglobulin) can be administered to help protect them from contracting the disease.