Treatments for Hepatitis C in Children

At Boston Children's Hospital, we take a multidisciplinary approach to the care of children with hepatitis C. 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 C are treated differently, but in either case, our goals in treating your child are to eliminate the virus and prevent the progressive liver damage that could lead to cirrhosis or liver cancer. There is one treatment we recommend for everyone: Anyone with hepatitis C should also be vaccinated against the two other major hepatitis viruses: hepatitis A and hepatitis B.

Acute hepatitis C

The usual treatment for acute hepatitis C 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 C

Children with chronic hepatitis C are treated with a combination of two drugs, peginterferon and ribavirin. The duration of treatment and the decision on when to start treatment depend heavily on which genotype of the virus your child is carrying (see Tests) and other factors such as severity of disease, other conditions or medications, and your and your child's readiness to start treatment. Because of concerns about the potential toxicity of these medications, we do not recommend giving them to any child with hepatitis C under age 3.

It is important to tell your doctor if your child has any other medical conditions including thalassemia, other viral infections, autoimmune conditions, or serious kidney disease. The other conditions would require that your doctor take a different approach to your child's hepatitis C treatment.

Two new medications, boceprevir and telaprevir, were recently approved for the treatment of adults infected with HCV genotype 1. However, these medications have not yet been approved for children. The Center for Childhood Liver Disease is launching clinical trials that will help determine whether these medications can help children with HCV genotype 1.

In the long term, children and adults with chronic hepatitis C 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. They should also have their liver function checked regularly to look for signs of advanced liver disease.

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 C. 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. The American Academy of Pediatrics says that children with hepatitis C can do anything that other children can.

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 normal family activities are fine.