Hepatitis C

What is hepatitis C?

Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). For a small number of people, hepatitis C, sometimes referred to as hep C, is a mild illness that clears on its own in a matter of weeks. In most cases, hepatitis C becomes a chronic condition that may progress to chronic liver failure or liver cancer.

According to the Centers for Disease Control, an estimated 3.5 million people in the U.S. 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 or other unsafe needle practices.

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 infection 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 are the symptoms of hepatitis C?

The majority of children with acute or chronic hepatitis C have no symptoms. As they age, the virus can cause ever-greater damage to the liver. In later stages, symptoms of hepatitis C may include:

  • tiredness
  • itchy skin
  • dark urine
  • muscle soreness
  • nausea
  • loss of appetite
  • stomach pain
  • jaundice

What causes hepatitis C?

Hepatitis C is caused by infection with the hepatitis C virus (HCV). The virus is passed from person to person through contact with blood infected with HCV. Mothers infected with HCV can pass the virus on to their children at birth. While this is the most common way for a child in the United States to become infected with HCV, it is unusual. A mother infected with HCV has about a 5 percent (1 in 20) chance of passing the virus to her child. About a quarter of infants infected with the virus clear it without treatment by the time they reach age 3.

Older children, especially teenagers, can contract HCV through injection drug use. The virus can spread through other forms of contact with potentially infected blood (e.g., needle stick in a health care setting). Tattoos and body piercings appear to be safe as long as they are done with sterile instruments.

What is the liver, and what does it do?

The liver is the second largest organ in the body and it helps the body in many ways:

  • the liver produces proteins that allow blood to clot normally, transport oxygen and support the immune system
  • it produces bile, a substance that helps digest food
  • it stores extra nutrients
  • it helps clean the bloodstream of harmful substances
  • it helps control blood sugar and cholesterol levels

How does hepatitis C affect the liver?

When infected, the liver becomes inflamed, which may cause the healthy, soft tissues in the liver to harden and scar. If not stopped, inflammation and scarring can lead to serious liver diseases such as cirrhosis of the liver or liver tumors. If the damage is severe enough, the liver may not perform all of its functions normally.

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 viral 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, treating adolescents with newly approved treatments for adults and conducting clinical trials to help make them available to children as young as 3 years of age.

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 use an ultrasound-based imaging technology called FibroScan that may be able to help doctors assess liver scarring without a liver biopsy.