Treatments for Hepatitis B Virus (HBV) in Children

 At Boston Children's Hospital, we take a multidisciplinary approach to the care of children with hepatitis B. Our Center for Childhood Liver Disease is one of the few centers with a dedicated team of specialists who are board-certified in pediatric hepatology.

Acute and chronic hepatitis B are treated differently, but in either case, our goals in treating your child are to control the virus and prevent the progressive liver damage that could lead to cirrhosis or liver cancer.

There is a very effective vaccine for hepatitis B that is now given to everyone in infancy. However, the vaccine can only protect one from an HBV infection, not treat existing infections. As a preventive measure, though, all children and adults with hepatitis B should be vaccinated against hepatitis A.

While the hepatitis B vaccine is extremely safe and has never been associated with any serious complications, some families choose not to have their children vaccinated, so there may still be children and young adults who are at risk for acquiring this serious infection.

Acute hepatitis B

The usual treatment for acute hepatitis B is no treatment. Rather, our doctors recommend rest, healthy eating, and drinking plenty of fluids to help the body clear the virus on its own. Your child will be tested periodically to see if the infection goes away on its own.

Chronic hepatitis B

Should your child have chronic hepatitis B and tests show that the virus is starting to damage the liver, your child's doctor will start treatment. Historically, this would consist of one of two drugs, interferon and lamivudine, though more often the specialists in the Center for Childhood Liver Disease would recommend enrolling your child in a clinical trial of new, potentially more effective drugs.

In the long term, children and adults with chronic hepatitis B should avoid alcohol, as it can speed the progression of liver disease, and should also be careful about which prescription or over-the-counter medications or supplements they take. In addition, it is important to maintain a healthy weight, since being overweight can make the liver disease progress faster and the treatment less effective, and if sexually active to practice safe sex so as to not pass the virus on to others.

He or she should have liver blood tests checked regularly to look for signs of advanced liver disease. People with chronic hepatitis B should also have periodic blood tests and ultrasound exams to look for any signs of liver cancer, even if laboratory test indicate that their viral infection is inactive. This is especially important after age 40, but doctors often begin surveillance earlier to detect the rare advanced cases in younger patients.

Care in school and other group settings

The doctors and nurses in the Center for Childhood Liver Disease are often asked whether schools, sports teams, and other group settings need to have special precautions in place for children with hepatitis B. Beyond the universal precautions that all schools, etc. should have in place to deal with contact and disposal of items with blood on them, the answer is no.

Care within the family

You can prevent the spread of the virus within the household by not sharing any items that may be exposed to blood, such as toothbrushes, razors, pierced earrings, nail clippers, etc.; all other family activities are fine.

Because it is not uncommon for many members of a single family to be infected with HBV without knowing it, you should talk with your doctor about having all members of your family tested for HBV, and about vaccinating all those whose test results come back negative (that is, who are not infected with the virus).