KidsMD Health Topics

Congenital Hepatitis B

  • Overview

    "If you have hepatitis B, your baby should receive hepatitis B immune globulin and the HBV vaccine in the first twelve hours after birth."

    Sandra Burchett, MD, MSC, Clinical Director, Division of Infectious Diseases, Boston Children's Hospital

     

    You’re likely to be confused and overwhelmed—not to mention scared—if your infant has been diagnosed with congenital hepatitis B. But you can play an active role in helping him get better. Developing a basic understanding of the condition is a great first step as you partner with your child’s health care team to form a treatment plan.

    • Hepatitis B is a disease of the liver that is caused by the hepatitis B virus (HBV). 
    • A pregnant woman can pass the virus on to her developing fetus.
    • If a mother is known to have HBV, her newborn baby should receive hepatitis B immune globulin and the HBV vaccine in the first twelve hours after birth.
    • If your baby is infected, she may have lifelong liver problems, such as scarring of the liver and liver cancer.

    How Children’s Hospital Boston approaches neonatal hepatitis B

    Our Division of Infectious Diseases treats neonatal hepatitis B in infants.

    Physicians in the Division of Infectious Diseases care for children and adolescents with a variety of infections.

    • In addition to treating children, we also are dedicated to researching better ways to diagnose, treat and prevent infectious diseases.

    How does Children’s treat neonatal hepatitis B?
    It’s important to begin treatment immediately after birth to reduce the potential damage to your baby’s liver.

    • If you have hepatitis B, your baby should receive hepatitis B immune globulin and the HBV vaccine in the first twelve hours after birth.

    Center for Childhood Liver Disease

    Children’s Center for Childhood Liver Disease has a multidisciplinary program that includes hepatology, surgery, interventional radiology, interventional GI endoscopy, and pathology.

    Newborn medicine

    At Children's Division of Newborn Medicine, we specialize in treating babies with a wide range of congenital and acquired conditions. Your baby will be seen by a specially trained team of physicians, nurses, respiratory therapists and other health professionals who routinely diagnose and treat newborns with critical illnesses.

    Essential support services
    Read about general information and resources for Children’s patients and their families.

    Congenital Hepatitis B: Reviewed by Sandra Burchett, MD, MSc, Clinical Director, Children’s Hospital Boston Division of Infectious Diseases

    Boston Children's Hospital 
    300 Longwood Avenue
    Fegan 5
    Boston MA 02115

     617-355-5837
     fax: 617-730-0716


  • In-Depth

    At Children’s Hospital Boston, we understand that you may have a lot of questions when your child is diagnosed with congenital hepatitis B, such as:

    • What exactly is it?
    • How did he get it?
    • What are potential complications in my child’s case?
    • What are our treatment options?
    • How will it affect my child long term?

    We’ve tried to provide some answers to those questions here, and when you meet with our experts, we can explain your child’s condition and treatment options fully.

    Background
    A baby may contract a hepatitis B virus (HBV) infection in the uterus if the mother has hepatitis B and passes it through her bloodstream to the baby.

    ·         The developing fetus is especially vulnerable to illness because its immune system is not yet strong enough to permanently fight off infection.

    Since a baby in utero cannot completely get rid of an infection, HBV remains in the body, and can lead to a hepatitis B infection, which may damage your baby’s liver and cause lifelong health problems.

    Causes

    A pregnant woman who has hepatitis B can pass it on to her unborn child.

    How is hepatitis B spread?
    HBV can be transmitted through blood, semen, vaginal secretions, or saliva.

    • HBV can also be spread from a pregnant mother to her fetus through the bloodstream.

    What is the likelihood that my baby will get hepatitis B?
    If you have hepatitis B, the chances are high that your baby will also have it. That’s why it’s important to have your baby vaccinated within 12 hours after birth.

    Symptoms

    Most babies born with hepatitis B never develop symptoms, but the virus can still be causing internal damage to the liver.

    If your child has symptoms, they may include the following:

    • jaundice
    • pain in the abdomen
    • dark urine
    • loss of appetite
    • nausea and vomiting

    Long-term outlook

    If your baby develops chronic hepatitis B, she may eventually require a course of antiviral medications or even a liver transplant. Children born with hepatitis B are also at greater risk for liver cancer and cirrhosis (scarring) later in life.

    Questions to ask your doctor

    If you’re worried about hepatitis B or are already infected, you may have many questions about how it can affect your baby.

    You may find it helpful to jot down questions as they arise—that way, when you talk to your doctor, you can be sure that all of your concerns are addressed.

    Here are some questions to get you started:

    • I’m planning to have a baby. Should I get vaccinated?
    • How can I reduce my exposure to the hepatitis B virus?
    • What can I do to prevent infection if I’m exposed?
    • Is there any way to prevent passing hepatitis B on to my baby?
    • What steps can we take if my baby does get infected?
    • What’s the long-term outlook for a baby born with hepatitis B?

    Prevention

    Although there is no cure for hepatitis B, there is an effective vaccine that can help prevent infection. It’s typically given as a series of three injections over six months and there’s no chance you’ll get the virus from the vaccine.

    • If you’re planning on becoming pregnant, ask your doctor about receiving the vaccine for hepatitis B.

    Is the vaccine dangerous?

    A vaccine, like any medication, is capable of causing serious problems, such as severe allergic reactions. But the risk of hepatitis B vaccine causing serious harm, or death, is extremely small; the vaccine is much safer than contracting the disease which it prevents, and most people who receive the vaccine do not have any problems with it.

    FAQ

    Q: What is hepatitis B?

    A: Hepatitis B is a disease of the liver that is caused by the hepatitis B virus (HBV).

    Q: Why is hepatitis B a problem?

    A: HBV can be spread from a pregnant mother to her fetus through the bloodstream.

    • If your baby is infected, she may have life-long liver problems, such as scarring of the liver and liver cancer.

    Q: What are the chances my baby will be born with hepatitis B?

    A: If you have hepatitis B, the chances are high that your baby will also have it. That’s why it’s important to have your baby vaccinated within 12 hours after birth.

    Q: How can congenital hepatitis B be prevented?

    A: Although there is no cure for hepatitis B, there is an effective vaccine that can help prevent infection. It’s typically given as a series of three injections over six months and there’s no chance you’ll get the virus from the vaccine.

    • If you’re planning on becoming pregnant, ask your doctor about receiving the vaccine for hepatitis B.

    Q: Is the vaccine dangerous?

    A: A vaccine, like any medication, is capable of causing serious problems, such as severe allergic reactions. But the risk of hepatitis B vaccine causing serious harm, or death, is extremely small; the vaccine is much safer than contracting the disease which it prevents, and most people who receive the vaccine do not have any problems with it.

    Q: How is congenital hepatitis B diagnosed?

    A: A simple blood test can check for the presence of the virus in your child’s bloodstream. However, if you have hepatitis B, it’s very likely that your baby will be born with it. That’s why it’s important that your baby receive hepatitis B immune globulin and the HBV vaccine in the first twelve hours after birth.

    Q: What symptoms might my baby have?

    A: Most babies born with hepatitis B never develop symptoms, but the virus can still be causing internal damage to the liver.

    If your child has symptoms, they may include the following:

    • jaundice
    • pain in the abdomen
    • dark urine
    • loss of appetite
    • nausea and vomiting

    Q: What are our treatment options?

    A: If a mother is known to have HBV, her newborn baby should receive hepatitis B immune globulin and the HBV vaccine in the first twelve hours after birth.

    Q: What is my child’s long-term outlook?

    A: If your baby develops chronic hepatitis B, she may eventually require a course of antiviral medications or even a liver transplant. Children born with hepatitis B are also at greater risk for liver cancer and cirrhosis (scarring) later in life.

    Q: What makes Children’s different?

    A: Our physicians are expert, compassionate and committed to focusing on the whole child, not just his condition—that’s one reason we’re frequently ranked as a top pediatric hospital in the United States.

    Physicians and researchers in our Division of Infectious Diseases are constantly learning more about how diseases develop and spread as well as how the body uses its defenses to fight back. 

    And at Children’s, we consider you and your child integral parts of the care team and not simply recipients of care. You and your care team will work together to customize a plan of care for your child.

    Top Ranking

    U.S. News & World Report ranks Boston Children's Hospital #1 in more specialties than any other pediatric hospital in the United States.

  • Tests

    The first step in treating your child is forming an accurate and complete diagnosis.

    For the mother:

    If you think you may have been exposed to the hepatitis B virus, your doctor can perform a blood test to check for the presence of the virus in your bloodstream.

    For the baby:

    If you have hepatitis B, it’s very likely that your baby will be born with it. That’s why it’s important that your baby receive hepatitis B immune globulin and the HBV vaccine in the first twelve hours after birth.

    After we complete all necessary tests, Children’s Hospital Boston’s experts meet to review and discuss what they have learned. Then we will meet with you and your family to discuss the results and outline the best treatment options.

    Envisioning the “baby-to-be”
    See how Children’s uses imaging techniques to make diagnoses before birth.
  • If your child has been diagnosed with congenital hepatitis B, you may be confused, frightened and overwhelmed. But you can rest assured that, at Boston Children's Hospital, your child is in good hands.

    Our physicians are expert, compassionate, and committed to focusing on the whole child, not just his condition—that's one reason we're frequently ranked as a top pediatric hospital in the United States.

    It's important to know the following about hepatitis B:

    • If you have hepatitis B, your baby should receive hepatitis B immune globulin and the HBV vaccine in the first twelve hours after birth.

    At Children's, we consider you and your child integral parts of the care team and not simply recipients of care. You and your care team will work together to customize a plan of care for your child.

    Prevention: The best treatment

    Because there's no cure for hepatitis B, it's important to not become infected.

    • If you're planning on becoming pregnant, ask your doctor about getting the vaccine for hepatitis B.

    Coping and support

    It's essential to remember that while hearing that your child is infected with hepatitis B can feel very isolating, many children and their families have been down this path before. We've helped them, and we can help you, too. There are lots of resources available for your family—within Children's, in the outside community and online. These include:

    Patient education:From the very first visit, our nurses will be on hand to walk you through your child's treatment and help answer any questions you may have. And they'll also reach out to you by phone, continuing the care and support you received while at Children's.

    Parent to parent: Want to talk with someone whose baby has been treated for hepatitis B? We can put you in touch with other families who have been through similar experiences and can share their experience.

    Faith-based support:If you are in need of spiritual support, we'll help connect you with the Children's chaplaincy. Our program includes nearly a dozen clergy representing Episcopal, Jewish, Lutheran, Muslim, Roman Catholic, Unitarian and United Church of Christ traditions who will listen to you, pray with you and help you observe your own faith practices during the time you and your child are in the hospital.

    Social work and mental health professionals: Our social workers and mental health clinicians have helped many other families in your situation. We can offer counseling and assistance with issues such as coping with your child's diagnosis, stresses relating to coping with illness and dealing with financial difficulties.

    On our For Patients and Families site, you can read all you need to know about:

    • getting to Children's
    • accommodations
    • navigating the hospital experience
    • resources that are available for your family
      Children's is on Facebook!

      Hear from our fans and become one yourself at Facebook.com/BostonChildrensHospital

     

     

  • Research & Innovation

    Research in Children’s Hospital Boston’s Division of Infectious Diseases includes both basic investigation and clinical research.

    Our research has the broad objective of learning more about how diseases develop and spread as well as how the body uses its defenses to fight back. 

    Investigators target viruses, bacteria and fungi that cause disease in community-wide infections in the United States, in infections of children with compromised immune systems and in global public health.

    Read more about these ongoing research studies.

    Treating chronic hepatitis B
    Maureen M. Jonas, MD, medical director of the Children’s Liver Transplant Program, has led research focused on liver disease in children with emphasis on viral hepatitis.

    • She was the principal investigator in several international trials where drugs that are effective in treating adults with chronic hepatitis were tested in children.
    • Dr. Jonas's work has been published in the New England Journal of Medicine, Hepatology, Pediatric Infectious Disease Journal and other major medical journals.

    Community-based care for newborns

    The Community Newborn Medicine Program at Children's cares for ill and convalescent newborns in a family-centered community setting. Our community-based Newborn Medicine faculty provide advanced newborn therapies in Neonatal Intensive Care Units (NICU) and in Special Care Nurseries (SCN) in several suburban medical centers that are affiliated with Children's.

    The affiliated nursery programs include:

    NICU

    SCN

     

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