Around 1 million children (out of 26 million) born every year are at risk of developing chronic HBV infection during their lifetime.

Hepatitis B is a disease caused specifically by the hepatitis B virus. The virus infects the liver and may result in inflammation (swelling) of the liver cells (hepatitis). This results in liver dysfunction. The spectrum of the disease ranges widely from asymptomatic disease or mild jaundice (which subside spontaneously) to chronic infection causing liver failure, permanent liver damage (cirrhosis) or liver cancer (hepatocellular carcinoma) says Dr. Parijat Ram Tripathy, MBBS, MD (Pediatrics), PDCC & DM (Pediatric Gastroenterology), Consultant Pediatric Gastroenterologist at Ankura Hospital for Women & children.

How common is Hepatitis B?

Hepatitis B is a disease of public health importance due to its high prevalence. In India, the prevalence rate is 2-4% in nontribal areas and 10-15% or more in tribal areas.

How does the disease spread?

• Perinatal transmission: From mother to her baby at the time of delivery. The infection rate among infants born to HBeAg-positive mothers is as high as 90 percent.

To decrease the infection among newborn babies it is recommended to test HBsAg in all pregnant women at the first prenatal visit and repeat the test late in pregnancy in those at high risk for HBV infection. It is also recommended to provide Hepatitis B vaccine to all babies after birth and to add hepatitis B immunoglobulin also where the mother is hepatitis B positive.

• Blood transfusion: The risk of transfusion has significantly reduced after strict testing of donated blood. Children requiring multiple transfusions, such as those with hemophilia and Thalassemia, are at increased risk of contracting HBV infection.
• Infected needles and syringes: This is common among intravenous drug users who share syringes and needles. Adolescents are specifically susceptible to this kind of transmission. Health care workers may get infections from needle stick injuries or through contact with infected blood. Patients may be infected through reused syringes or needles. With the use of disposable syringes and needles and safe injection practice, this is declining.
• Horizontal transmission: Children may acquire HBV infection through horizontal transmission via minor breaks in the skin or mucous membranes during close bodily contact with other children or family members. This is one of the main modes of transmission amongst children in India. It can rarely be transmitted via contaminated household articles such as toothbrushes, razors, and even toys mainly through saliva. Children in facilities such as remand homes also carry an increased risk of horizontal transmission. Unsafe sex due to lack of knowledge can also lead to hepatitis B among adolescents.

Symptoms of Hepatitis B

• Achy muscles or joints.
• Stomach pain.
• Loss of appetite.
• Mild fever.
• Loose stool (diarrhea).
• Lack of energy.
• Having yellow skin or eyes (jaundice).
• Being sick to your stomach.
• Yellow urine.
• Blood in vomiting
• Altered behavior
• Swelling in abdomen and body

How to prevent Hepatitis B

• Immunization
• Hepatitis B immunoglobulin to babies born to infected mothers, at birth
• Always use disposable syringes and needles
• Safe blood transfusion
• Education to adolescents about sexually transmitted diseases

About the author- Dr. Parijat Ram Tripathy –  Consultant Pediatric Gastroenterologist at Ankura Hospital for Women & children