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Hepatitis C: What Parents Need to Know

By: Michael Narkewicz, MD, FAAP

Hepatitis C virus (Hep C or HCV) 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

Infants and children with HCV infection usually do not have symptoms. For those who develop symptoms, the infection may begin as nothing more than a mild flu-like illness. Some people experience one or more of the following:

  • 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 (yellowing of the whites of the eyes or the skin)

Infants with HCV infection may also have an enlarged liver or spleen, grow more slowly, or fail to gain weight.

Is there a test for hepatitis C?

Hepatitis C virus (HCV) infections have been increasing, including among babies and children. The U.S. Centers for Disease Control and Prevention recommends that people get tested for HCV infection during every pregnancy. And, if you have hepatitis C, your baby should be tested as early as 2 months old. See the box below to learn more about HCV tests. Hepatitis C is curable in more than 95% of cases.

Test type

What does a positive test mean?

Age for testing


HCV antibody test

Positive test indicates current or past infection

18 months and up

In newborns born to a pregnant person with HCV, this test may be falsely positive due to passage of the antibody from pregnant person to the newborn infant

HCV vir​us test

Positive test indicates active infection

After 2 months of age

Can be positive before 2 months of age and not indicate infection

To diagnose HCV infection, your pediatrician will examine your child and test your child's blood for the virus. If your baby tests positive for hepatitis C, they should be referred to a pediatrician or health care provider who has experience managing hepatitis C.

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 or school. However, because it can be spread through contact with blood, parents or 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.

For most infants, the infection is passed from pregnant person during childbirth. The risk of infection is about 1 in 20 for the infant.

Hepatitis C virus can be spread through sexual contact. Ideally, infected adolescents and young adults should avoid having sex. If they choose to have sex, they are urged to use latex condoms to help prevent the spread of HCV. Hepatitis C can also spread through shared needles. HCV infection can cause liver damage. Anyone with HCV is urged to avoid alcohol, which can speed up damage to their liver.

Long-term effects of HCV infection

Some children with HCV infection have long-lasting 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 waste 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 are also at risk for other serious diseases, including liver cancer.

Current treatments are very effective

There is no vaccine to prevent hepatitis C. The good news is that very effective treatments are available. This includes 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.

Last Updated
American Academy of Pediatrics (Copyright @ 2023)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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