By: Michael Narkewicz MD, FAAP
Hepatitis C virus (Hep C or HVC) is a virus that can cause liver disease. Although most children and adolescents recover from the initial phase of HCV infection, 60-80% of them may develop signs of chronic liver infection. This can lead to much more serious liver problems and possibly death. Hepatitis C virus is the cause of approximately 10,000 deaths each year in the United States.
Symptoms of HCV infection
Infection with HCV is usually causes no symptoms in infants and children. For children and adolescents, it may begin as nothing more than a mild flu-like illness. Some people may experience one or more of the following:
Flu-like symptoms (body aches, fever, diarrhea, or nausea)
Extreme tiredness
Lack of appetite or weight loss
Dark yellow urine
Light, clay-colored bowel movements
Stomach pain, especially in the upper right side of the abdomen
Jaundice (a yellowing of the eyes and skin)
Infants with HCV infection also may have an enlarged liver or spleen, grow more slowly, or fail to gain weight.
If your child has some of the symptoms of HCV infection, or if your child has been exposed to anyone with HCV, contact your pediatrician. To diagnose HCV infection, your pediatrician will examine your child and test your child's blood for the virus.
How HCV is spread
Hepatitis C virus cannot be spread by touching, hugging, or kissing. So, children with HCV infection can participate in all normal childhood activities and should not be excluded from child care centers or schools. However, because it can be spread through contact with blood, parents of children with HCV infection should make sure household items such as toothbrushes, razors, nail clippers, or other items that may contain small amounts of blood, are not shared.
Most infants acquire hepatitis C at birth from a mother who has hepatitis C. The risk is about 1 in 20 for an infant born to a mother with hepatitis C.
Hepatitis C virus can be spread through sexual contact. Infected teens and young adults should be strongly advised to avoid having sex. If they are going to have sex, they need to use latex condoms to prevent the spread of HCV. Hepatitis C can also be spread through sharing needles. Drinking alcohol also should be avoided by anyone with HCV infection because alcohol can speed up liver damage.
Long-term effects of HCV infection
In some children, HCV infection can lead to persistent liver disease that can lead to cirrhosis or advanced scarring of the liver. Cirrhosis occurs when the liver cells die and are replaced by scar tissue and fat. The liver eventually stops working and can no longer remove wastes from the body. Children and adolescents who develop cirrhosis of the liver because of chronic HCV infection may require a liver transplant to survive. Children infected with HCV also are at risk for developing other serious liver diseases, including liver cancer.
Current treatments are very effective
While at the present time there is no vaccine to prevent hepatitis C, there are very effective treatments available. Recent medical advances have resulted in the approval of several new drugs for HCV infection for children 3 years old and up that can cure the virus in 95-98% of children and adolescents.
More information
About Dr. Narkewicz
 Michael Narkewicz MD, FAAP, is a Professor of Pediatrics at the University of Colorado School of Medicine Section of Pediatric Gastroenterology, Hepatology and Nutrition. He is also a pediatric gastroenterologist with the Digestive Health Institute at Children’s Hospital Colorado,
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