chronic viral hepatitis hepatitis b hepatitis c

WHAT IS HEPATITIS?

Hepatitis is a generic term that’s used to describe the inflammation or swelling of the liver. Depending on the progression of the condition, hepatitis can be acute – the condition that flares up suddenly and then goes away; or chronic – a long-term condition that usually has more subtle symptoms, but progressive liver damage.

WHAT CAUSES HEPATITIS IN CHILDREN?

In India, Viral Hepatitis is a major health care burden and is caused by four major types of viruses – A, B, C & E. Among these, Hepatitis A and Hepatitis E affect children in India, while Hepatitis B & C are more common among adults.

Hepatitis A:

Hepatitis A Virus or Hep A Virus is the most common virus that causes hepatitis in children. The virus is present in the stool and blood of an infected person and is usually transmitted through the fecal-oral contact i.e. children can get hepatitis A when they eat or drink something that has the Hep A virus in it. It usually spreads in the following ways:

• Eating food that is made by an infected person who probably didn’t wash his/ her hands properly after using the bathroom.
• In our country, one of the most common ways is the consumption of water that has been contaminated by infected feces.
• Food or drinks that are bought from the market can also cause the disease.

Acute Hepatitis in children and also adolescents can be attributed to the Hepatitis A Virus. Hepatitis is acute if it resolves within six months, and chronic if it lasts for more than six weeks. Acute hepatitis can resolve on its own, progress to chronic hepatitis, or can result in acute liver failure.

Hepatitis E:

The Hepatitis E Virus or the Hep E Virus, similar to the Hep A Virus, can be transmitted by the fecal-oral route and like Hepatitis A, Hepatitis E is also common in developing countries such as ours. Hepatitis E mostly affects adolescents and adults and is not so common in children. It is also responsible for acute hepatitis.

Other causes of Hepatitis:

• The other causes of hepatitis include certain medications, toxins, other infections, autoimmune diseases, and non-alcoholic steatohepatitis (NASH).
• Some types of hepatitis is not caused by viruses and can happen because of a bacterial infection, or because of the body’s own immune system attacking the liver. The latter is known as autoimmune hepatitis.
• Hepatitis B & C in children generally occur from the mother during pregnancy or childbirth or can be acquired through infected blood.

WHAT ARE THE SYMPTOMS OF HEPATITIS IN CHILDREN?

Symptoms of Hepatitis are different each child and it’s also possible that many children don’t show any symptoms at all.

One of the best-known symptom of Hepatitis is jaundice that makes the child’s skin or the white portion of the eyes turn yellow. But, not everyone who gets hepatitis gets jaundice. Most children complain of flu-like symptoms – weakness, tiredness and sick to the stomach.

Symptoms of acute hepatitis may include:

• Flu-like symptoms
• Jaundice i.e. yellowing of the skin and/ or the white portion of the eyes
• Fever
• Nausea or vomiting
• Loss of appetite
• Abdominal pain
• Diarrhea
• Joint pain
• Sore muscles
• Clay-coloured stool
• Dark-coloured urine

In some cases, children with hepatitis have extremely mild symptoms or no symptoms at all. This is why hepatitis is also known as the ‘silent’ disease. Also, in some cases the symptoms of hepatitis may appear like the symptoms of other health issues, so to be sure that your child has hepatitis, you’ll need to get some tests done.

HOW IS HEPATITIS DIAGNOSED IN CHILDREN?

To confirm the diagnosis of hepatitis, the doctor or gastroenterologist will need to get a Blood Test called a Hepatic (Liver) Function Panel test done to check the functioning of the liver. If this test shows signs of liver inflammation, the gastroenterologist may do more blood tests to look for a cause – for example, a blood test that checks for antibodies to specific viruses.

Since, signs of liver inflammation are common to other mild viral illnesses, the gastroenterologist will need to monitor the child’s liver function with repeat blood tests till the time the inflammation in the liver clears up.

In some cases, the gastroenterologist might also ask of for an imaging test – an ultrasound scan of the belly as this proves to be extremely effective in examining the liver.

And is some cases, a liver biopsy would also be done to confirm the condition – a needle is used to take a small sample of the liver and is examined under a microscope.

OUR APPROACH TO TREATMENT OF HEPATITIS:

The treatment depends on the cause of the hepatitis. Most children with viral hepatitis do not need any specific treatment as it often clears up on its own but sometimes an antiviral medicine would be given.

While Hepatitis A and B are preventable with vaccines, gastroenterologists may give medications to treat acute viral b hepatitis.

For children whose hepatitis is caused by a medicine or something else in the environment, the treatment, the first step is to stop the medicine or avoid the substance that caused the hepatitis.

Autoimmune hepatitis may be treated with steroids to suppress the immune system. And a liver transplant may be an option in both acute and chronic liver failure.