Hepatitis B factsheet

Introduction

Hepatitis B (HBV) is a virus that can cause inflammation and damage to the liver.

HBV is spread by direct contact with body fluids like blood that carry the virus.

Children and teenagers can get HBV through:

birth, when the mother has an active HBV infection
sharing needles
getting a piercing or tattoo with equipment that is not sterile or free of germs
using medical equipment that is not sterile or free of germs
sexual contact with a person who has HBV
sharing tools like razors or toothbrushes with a person who has HBV.

HBV can cause severe illness when a child reaches adulthood, including:

cirrhosis - scarring on the liver
liver cancer
needing a liver transplant - a procedure that replaces the damaged liver with a healthy donated one.

Signs and symptoms

Most children with HBV do not have any symptoms.

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

loss of appetite
loss of energy
pain around the liver, on the upper right side of the belly
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.

Children are at risk of spreading HBV:

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

Diagnosis

HBV can be diagnosed through a blood test. This can be done by your local doctor and is recommended for:

babies born to a mother with HBV at around nine months of age
children and teenagers who have had contact with HBV from high-risk activities like
- sharing needles
- piercing or tattoo equipment that is not free of germs
- sexual contact
- sharing hygiene tools with a person who has HBV.

Treatment

Children with HBV will need regular check-ups with their doctor or local HBV clinic to make sure:

they are growing well
their liver is healthy and working properly
medications that affect the liver are managed properly
they have their childhood vaccinations.

Treatment of HBV will depend on your child. Your child's treatment team will discuss options with you and your child.

Some children will clear the virus from their bodies without treatment.

Treatment at home includes:

rest
eating small meals more often
drinking fluids
avoiding alcohol.

In rare cases, children may need treatment with antiviral medicines that prevent the virus from growing.

Management

Chronic hepatitis B

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

Chronic hepatitis B can put your child at risk of:

liver scarring
liver failure
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.

Hepatitis B vaccination

The best way to prevent your child from contracting HBV is to have them immunised. The HBV immunisation is available for free under the National Immunisation Program Schedule at:

birth
6-8 weeks
four months
six months.

Side effects of the HBV 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.

Families of children diagnosed with HBV are strongly encouraged to get tested and have the HBV immunisation.

Children with HBV should also get the hepatitis A immunisation.

Pregnancy and breastfeeding

If you have HBV 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 receive the following injections after birth:

the HBV vaccination
an injection of hepatitis B immunoglobulin.

These injections lower the risk of your baby getting HBV to 10%.

HBV does not spread through breast milk. It is safe to breastfeed as long as nipples are not cracked or bleeding. If your nipples are cracked or bleeding, you will need to stop feeding with the affected nipple.

Hand-express or pump milk before discarding it and return to regular breastfeeding once it has healed. Speak to your doctor if you are unsure.

Blood awareness and safety

It is important to take care and avoid contact with another person's blood, urine, and other body fluids.

You can do this by:

cleaning up blood spills quickly, using gloves
covering cuts with a waterproof band-aid
not sharing hygiene tools like razors, toothbrushes, or nail clippers.

School and daycare

You are not required by law to tell daycare and school that your child has HBV.

You can choose who to tell, including friends and family. It is a good idea to tell your child's doctor and dentist so they can give the right care and support.

You may need to tell others that your child has HBV in certain situations. This can include: