Hepatitis B factsheet

Introduction

Hepatitis B is a virus that causes inflammation of the liver. The hepatitis B virus is spread by direct contact with infected body fluids including:

blood
saliva
semen
fluid or mucus from the vagina.

Children and teenagers can be at risk of getting hepatitis B from:

unsterilised, shared or discarded needles in the community.
piercings done with unsterilised tools
sexual contact.

The most common way that children are infected with hepatitis B is when the virus is passed on to a baby during pregnancy or birth.

Signs and symptoms

Hepatitis B infection usually does not cause any symptoms in children. Even though there are no symptoms, hepatitis B can cause advanced liver disease as your child gets older.

If there are symptoms, they may start slowly a few months after infection and can include:

loss of appetite
loss of energy
stomach pain around the liver, on the upper right side
vomiting
fever and rash
jaundice - yellow skin and eyes.
dark urine and pale or white poo
painful or swollen joints.

Symptoms can be worse in children with lower immune systems or liver disease. Your child is considered infectious with hepatitis B:

up to 3 months before they show any symptoms
until the virus has been cleared from their body or is managed with medication.

Diagnosis

Lack of symptoms in children can make hepatitis B difficult to diagnose. Your child’s doctor will be able to make a diagnosis based on any symptoms that do show and blood tests.

Hepatitis B tests should be done for children and teenagers who:

are born to a mother with hepatitis B
have symptoms of hepatitis or have unexplained abnormal liver tests
have come into contact with a dirty or used needle
have had sexual contact.

Treatment

Most children will recover from the virus within weeks or months.

Treatment is focussed on relieving symptoms, reducing the spread, and preventing complications. Treatment should include:

rest
eating small meals more often
drinking fluids
reviewing medications that affect the liver with your child's doctor
avoiding alcohol.

Children who have the virus longer than six months can develop chronic hepatitis B.

Chronic hepatitis B can put your child at risk of liver scarring, liver failure and liver cancer.

Children with chronic hepatitis B will need to:

have general health and liver checks every 6-12 months
take anti-viral medicines
eat a healthy diet and exercise to keep their liver healthy
avoid drinking alcohol and taking drugs.

Management

Prevention

The best way to prevent your child from contracting hepatitis B is to have them immunised. Protection against hepatitis B is available free-of-charge under the National Immunisation Program Schedule at the following ages:

birth
6-8 weeks
4 months
6 months.

Side effects of the vaccine can include:

pain, redness and swelling at the injection site
low-grade temperature or fever
mild headache.

Immunisation cannot cure someone who is already infected with the hepatitis B virus.

If your child is diagnosed with hepatitis B, your family should get tested and get the immunisation.

Children with hepatitis B should also receive the hepatitis A immunisation.

Pregnancy and breastfeeding

If you have hepatitis B and are pregnant, you can speak to your doctor about medicine that can reduce the chance of passing the virus on to your baby. Your baby will also get a special injection of antibodies at birth alongside the hepatitis B immunisation.

Your baby should then be tested for hepatis B 3 months after their final hepatitis B immunisation.

You can safely breastfeed your infant even if you have hepatitis B.

If you have hepatitis B, your baby will receive an injection of hepatitis B immunoglobulin alongside the hepatitis b immunisation at birth. 95% of babies born to mothers with hepatitis B will not become infected if they have these immunisations at birth.

Avoid breastfeeding and speak to your doctor as soon as possible if your nipples are cracked and/or bleeding and you have hepatitis B.

Blood awareness and safety

If your child has hepatitis B, you and your family should practise blood awareness. This means being careful around your child’s blood, for example when you treat a wound or bite, and knowing how to manage bleeding safely.

Tips for blood awareness and safety include:

not sharing things like toothbrushes and razors with others
using disposable gloves when cleaning up any blood or bodily fluids
cleaning spills that involve body fluids with paper towel before cleaning with detergent and cold water or bleach.

You are not required by law to inform schools and day care that your child has hepatitis B. Schools and day care should always practise standard precautions when dealing with blood and body fluids from any child in their care. This means that they should treat every child’s bodily fluid like it is infectious.