We have heard many times about hepatitis in adults, but what about hepatitis in children? Is hepatitis a dangerous disease? Which type of hepatitis is dangerous? What are the symptoms of hepatitis in children and how can it be prevented? In general, hepatitis is a process in which the liver is damaged by the inflammatory cells of the immune system and the cells of the liver tissue itself. Hepatitis is one of the diseases that can affect children and may exist for a long time without causing any symptoms. In this article, we are going to examine **hepatitis in children**, so stay with us until the end of the article. How does hepatitis occur in children? Hepatitis occurs when liver cells become infected with a virus. This disease can destroy and damage liver cells. Hepatitis is classified according to its duration (acute when it lasts less than 6 months or chronic), according to its pathological pattern, and according to its cause. Generally, hepatitis virus is divided into five types A-B-C-D-E. Hepatitis A is the most common type of this disease in children, but the child may be infected with any other type. Hepatitis A in children Hepatitis A is an acute but self-limiting disease. This virus is part of the heterogeneous group of hepatitis viruses that cause similar clinical and acute diseases. Acute hepatitis is the initial manifestation of the disease and does not cause chronic infection. The range of clinical manifestations in children is different. Younger children usually have milder or asymptomatic disease compared to older children, teenagers and adults. The highest rate of infection occurs in children aged 5 to 14 years. Manifestations of hepatitis in children - It has variable manifestations and the icteric phase occurs after the pre-icteric phase: - Asymptomatic (there is no liver enzyme disorder) - Subclinical (without symptoms, brief disturbances in liver enzymes) - Without jaundice (symptomatic but without jaundice in babies and children) - Liver failure Young children are usually less symptomatic than adults. The initial symptoms last up to 5 days and include: - Fever in children - Nausea - Vomiting - Muscle weakness and pain - Anorexia - Headache in children - Diarrhea and abdominal pain - Fatigue Late symptoms last a few days to a month, including dark urine, jaundice, and hepatomegaly (enlarged liver). What are the causes of hepatitis in children? As mentioned, there are 5 types of hepatitis viruses that cause disease in children. In total, the most important causes of this disease are: - Virus type A-B-C-D-E - Cytomegalovirus (part of the herpes virus family) Epstein-Barr virus that causes mononucleosis. - Herpes simplex virus (herpes virus) - Varicella zoster virus (chicken pox) is one of the complications of this hepatitis virus, but it rarely occurs in children. Enteroviruses are a group of viruses that appear in children and include echoviruses and coxsackieviruses. - German measles virus (rarely causes hepatitis) ### Ways of transmission of viral hepatitis How hepatitis is transmitted depends on its cause: 1. Hepatitis A virus by eating food contaminated with feces, traveling to countries where hepatitis A is common, but blood transfusion rarely causes hepatitis A. 2. Hepatitis B and C are transmitted through body fluids such as blood, and a person can transmit the disease to others before symptoms appear. How is hepatitis diagnosed in children? The doctor will first examine the child to find inflammation or enlargement of the liver, and then the following tests will be performed: **Blood sample:** Blood tests are performed to detect liver enzymes, liver function, antibodies and polymerase chain reaction in order to detect the type of virus that causes it, and coagulation tests are performed for children. **Diagnostic radiography:** Abdominal CT scan may be done to clearly see the internal organs to determine the size and shape of the liver, ultrasound images or MRI images. **Liver biopsy:** This is to clearly identify the type of inflammation and its cause, as biopsy is the most accurate way to find the cause of inflammation. Treatment of hepatitis A in children Initial treatment is supportive and antiviral treatments are not recommended. Treatment of hepatitis in children is usually done by reducing and curing the associated symptoms and here are some tips: - Rest your child until the symptoms subside, as he may feel tired and weak. - In case of vomiting, give the child plenty of fluids to prevent dehydration. - Nausea may make it difficult for the child to eat, so instead of feeding full meals, give snacks such as fruit juice. - Blood test, because it can determine if the disease is progressing or not. - Admission to the hospital, this is done in severe cases. - Liver transplantation is performed in case of liver failure in the final stage. Note that vaccination of the child or injection of Ig is recommended before contact with the virus and infection. Hepatitis A vaccine is prescribed to all children aged 12 to 23 months. Also, Ig will be given to children younger than 12 months. Vaccination is also required for unvaccinated people who have been in contact with the patient. Complications of hepatitis Hepatitis A usually does not cause any complications and resolves on its own, but for hepatitis B and hepatitis C, some complications include: - Chronic inflammation of the liver - Liver failure - Liver cancer Fortunately, vaccines are the most effective way to prevent hepatitis. There are vaccines for hepatitis A and B viruses, but there are no vaccines for hepatitis C, D, and E viruses. **last word** Hepatitis A infection is not only limited to adults, but children and babies can also get it due to many factors and cause a group of uncomfortable symptoms in them. There is no definitive cure for hepatitis A, but the infection clears up on its own within two months or up to six months. It is better to know that the probability of death of children due to hepatitis is only 1-2%. In the end, it is recommended to get vaccinated to prevent hepatitis in children, and if symptoms of the disease appear, refer to **the best pediatrician in Tehran**.