What is Hepatitis C?
‘Hepatitis’ is an inflammation of the liver. There are many causes of hepatitis, and in children it is usually caused by a viral infection. Hepatitis C (HCV) is one of the viruses that can cause hepatitis.
There are six strains (or types) of HCV. These are called “genotypes”. HCV genotypes 1 and 3 are the most common types found in Australia.
If a person has the hepatitis C virus for more than six months it is called chronic hepatitis C infection. Some people, both children and adults, can clear the hepatitis C virus themselves, after being exposed.
Currently, there is no immunisation available to protect against hepatitis C.
Symptoms of hepatitis C
The hepatitis C virus infection may cause no obvious symptoms, even though liver damage may be occurring. For some people with chronic hepatitis C infection, it can cause chronic liver disease. Symptoms include: jaundice (yellowing of the whites of the eyes and the skin), tiredness, nausea, fever and lack of appetite, but this is rare in children.
Who gets hepatitis C virus?
The hepatitis C virus is spread by blood to blood contact. It is rarely spread by other body fluids. People at extra risk are intravenous drug users who share needles, and people who received blood transfusions before February 1990. This is because screening of blood for hepatitis C began in 1990 in Australia. Hepatitis C can be spread sexually, although this is uncommon.
Can babies catch hepatitis C from their mothers?
Yes, a mother can transmit the virus to her baby.
This is known as vertical transmission. It is thought to occur in-utero or during delivery. Of 100 babies born to mothers who have Hepatitis C, approximately 5-7 of those babies (5–7%) will obtain the virus.
Hepatitis C virus has not been shown to be transmitted through breast milk and therefore, breastfeeding is encouraged. If however the mother has cracked and bleeding nipples, the milk should be expressed and discarded until nipples have healed.
What are the long term effects?
Children with chronic hepatitis C virus infection usually feel perfectly well. After many years of infection they may develop cirrhosis of the liver (increasing and permanent scarring of the liver) or liver cancer, but this is unusual in childhood. Chronic hepatitis C infection with liver disease and/or liver cancer is the most common reason for needing a liver transplant in adults. Children rarely need a transplant.
It is hard to predict who will go on to develop serious liver problems and so it is important for all children infected with HCV to be monitored.
Children should be immunised against other hepatitis viruses like hepatitis B and hepatitis A. It is also recommended to; have a good diet, exercise, maintain a healthy weight and avoid alcohol and drugs in adult life.
Can hepatitis C be treated?
Yes, many adults and some children are treated with Pegylated Interferon and Ribavirin.
From March 2016, oral only treatment has been approved on the PBS for adults and in April 2020, this was made available to children 12 years and older. Clinical trials of these oral medications have occurred, in the hope that it will also be available for treating younger children in the future. Children 11 years and younger will need to continue being monitored until the treatment becomes available to them.
The length of treatment is as little as 8 weeks with children receiving treatment monitored by a specialist. The treatment is dependent on how the child’s liver is functioning, the impact of symptoms on their life, blood results, liver biopsy and ultrasound results.
Can hepatitis C virus be caught?
Q: From other children playing together or in the classroom or from general contact like kissing and cuddling?
A: No.
Q: From a blood transfusion in hospitals today?
A: There is a very low risk in Australia, but infection can occur if a blood donor was recently infected and their hepatitis C test was not yet positive.
Who should be tested for hepatitis C virus?
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Children born to a mother with the hepatitis C virus
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Anyone who has symptoms of hepatitis or anyone with unexplained abnormal liver tests
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Anyone at risk of hepatitis C due to exposure to blood or blood products before February 1990
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People who inject drugs.
Remember:
- HCV is spread by contact with infected blood
- Check your hepatitis C status if you are at risk of hepatitis C
