Hepatitis C

What is hepatitis C?

Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). For many people, hepatitis C, sometimes referred to as hep C, is a mild illness that clears on its own in a matter of weeks. In some cases, hepatitis C becomes a chronic condition that requires lifelong care.

According to the Centers for Disease Control, an estimated 3.5 million people in the United States are living with hepatitis C and there are more than 40,000 new cases of hepatitis C in the country each year. Because most children and adults with hepatitis C do not have specific symptoms, many do not realize they are infected.

HCV spreads through the blood. The most common way children become infected with hepatitis C is during the birth process if they are born to a mother with the virus. Researchers do not believe a mother can pass the virus to a fetus in the womb. Older children can become infected through injection drug use.

There are two phases of hepatitis C: acute and chronic.

  • Acute hepatitis C is a mild illness that children and adults experience within the first six months of infection. As many as a quarter of children infected with HCV clear the virus on their own without any treatment during the acute phase.
  • Chronic hepatitis C is a serious, long-term illness that develops when the virus remains in the blood. Over the course of decades, chronic hepatitis C can damage the liver to the point that a liver transplant becomes necessary.

What is the difference between hepatitis B and hepatitis C?

Hepatitis B and hepatitis C are caused by different viruses. Other differences include:

More children and adults are infected with hepatitis C.

  • There are an estimated 19,000 new hepatitis B infections a year.
  • There are an estimated 30,000 new hepatitis C infections a year.

The rate of mother-to-child infection is higher with hepatitis B.

  • According to the World Health Organization, a mother with hepatitis B has up to a 90 percent chance of passing the virus to her child while giving birth.
  • A mother with hepatitis C has about a 5 percent (1 in 20) chance of passing the virus to her child while giving birth.

There is a vaccine for hepatitis B.

  • A child born to a mother with hepatitis B should receive the vaccine within 12 hours after birth. This will be the first of three doses.
  • There is currently no vaccine for hepatitis C.

The risk for chronic infection is higher for young, unvaccinated children with hepatitis B, but the risk goes down as children get older.

  • Younger children who have not been vaccinated are at the highest risk of developing chronic hepatitis B. Among unvaccinated children, 90 percent of babies, 20-50 percent of toddlers aged 1-5 years old and 6-10 percent of older children progress from acute to chronic hepatitis B.
  • Between 20 and 30 percent of children and adults with acute hepatitis C develop chronic hepatitis C.

Despite all of the differences, hepatitis B and hepatitis C are also similar in many ways:

  • The viruses that cause them spread when the blood of someone infected with the virus enters the body of another person.Typically this happens when people share needles to inject drugs.
  • Neither virus is spread by hugging, kissing, coughing or sneezing.
  • Both start with an acute stage and sometimes progress to a chronic stage.
  • A child's immune system can often clear the body of either virus without medication.
  • If either virus progresses to the chronic stage, the child may develop cirrhosis or liver cancer as an adult.

How we care for hepatitis C

The Center for Childhood Liver Disease at Boston Children's Hospital is one of the leading centers in the world for the care of children with hepatitis C. The center’s director, Maureen Jonas, MD is a national leader in the care, diagnosis and treatment for children with hepatitis. Dr. Jonas, along with her team, wrote the clinical guidelines that shape the way pediatric GI specialists and pediatricians around the country treat hepatitis C.

In addition to the standard treatments, our team of certified pediatric hepatologists is also at the forefront of treatment research, actively working to help make newly approved treatments for adults with hepatitis C available to children.

Our areas of innovation for hepatitis

Liver biopsies provide a great deal of information about the extent of damage in a child’s liver, but the procedure is invasive and can be both painful and risky. Researchers at Boston Children’s are investigating an ultrasound-based imaging technology called Fibroscan that may be able to help doctors assess liver scarring through a virtual biopsy.