Hepatitis B
Hepatitis B virus (HBV) is a virus that primarily affects the liver and is transmitted from person to person through blood or from mother to newborn during childbirth if the mother is a carrier of the virus. In some cases of infection, the body can clear the virus completely, but in others, the virus establishes itself in the liver and causes chronic inflammation. This inflammation leads to complications over time. In adolescents and adults (as opposed to infants), about 90% of cases are expected to fully recover after the initial infection. Only about 10% progress to chronic hepatitis B. In contrast, about 90% of infants born to carrier mothers progress to chronic hepatitis B.
Chronic hepatitis B often presents no symptoms during childhood and is detected through abnormal blood test results. Without treatment, the infection can lead to prolonged liver damage and the development of chronic liver inflammation, liver cirrhosis, or even liver cancer.
Hepatitis B infection is diagnosed through blood tests that confirm the presence of the virus in the blood. Typically, repeated blood tests are required to assess the progression of the infection, along with liver biopsy or ultrasound. The best treatment is prevention, and since the introduction of routine vaccination for all newborns in Israel (a shot immediately after birth and two follow-up shots at one and six months old), infection rates have been steadily decreasing. Newborns born to carrier mothers are treated immediately after birth by giving them antiviral drugs in addition to the routine vaccination. This combination is effective in significantly reducing the transmission of the infection.
In cases of chronic hepatitis B infection, a hepatologist will assess the severity of the infection and its implications to determine the most appropriate timing for treatment. Treatment often involves a drug called interferon alpha-2b, which helps the immune system control the infection. Another therapeutic option is antiviral medication that prevents viral replication. Continuous monitoring over time is necessary for children who receive treatment to detect any viral rebound and assess later complications to prevent them. Another important aspect of hepatitis B treatment is preventing liver damage by other factors. Therefore, it is recommended for children to receive vaccination against hepatitis A and to avoid alcohol consumption.
Hepatitis C
Hepatitis C virus (HCV) is transmitted through blood from an infected person. It's a chronic disease, although liver damage may appear many years after infection. The risk of transmitting HCV from mother to infant is significantly lower compared to hepatitis B. However, there is no vaccination available for hepatitis C that can further reduce infection rates. HCV infection often doesn't cause symptoms in children, but chronic liver inflammation can lead to long-term complications. Diagnosis of hepatitis C is done through a series of blood tests to detect the virus and assess the degree of liver involvement.
Untreated HCV infection can lead to slow and prolonged liver damage over years and may increase the tendency for liver cancer later on. Therefore, early treatment aims to prevent these later complications. Treatment often involves a series of weekly injections of interferon, combined with oral antiviral drugs. Innovative treatments with improved safety profiles are being researched in clinical trials, and it is hoped that they will become available for children in the future.