Hepatitis After Childhood Cancer


Children with cancer often receive blood and blood products as part of their treatment. Today, the U.S. blood supply is among the safest in the world. But, before the blood supply was routinely screened for viruses, some blood products contained hepatitis virus, which can cause infection of the liver.

What Is Hepatitis?

Hepatitis is an infection of the liver that makes it stop working well. Most often, a virus causes the infection. The different types of hepatitis are named after the viruses that cause them. For example, hepatitis B is named after the hepatitis B virus that causes it.

The two main types of hepatitis that you can get from receiving infected blood products are hepatitis B and hepatitis C.

Many people don't have symptoms when they are first infected. Some have flu-like symptoms, such as fatigue, loss of appetite, nausea, vomiting, or low-grade fever. Others have symptoms that suggest that their liver is not working well. These include yellow eyes and skin (jaundice), dark urine, severe itching, or pale stools. In rare cases, people may become very sick and develop liver failure.

Hepatitis may go away and cause no further health problems. But many people who were infected with hepatitis B or C as children have chronic, or ongoing, hepatitis infection. People with chronic hepatitis may have no symptoms, but they are at risk for liver damage. Signs of liver damage include enlargement of the liver and spleen, swelling or collection of fluid in the abdomen, yellow eyes and skin (jaundice), and problems with blood clotting. In rare cares, liver cancer can develop.

Am I at Risk?

Screening of donated blood for hepatitis B began in 1971 and the most accurate screening for hepatitis C began in 1992. If you received the following blood or serum products before these dates you are at risk for hepatitis.

  • packed red blood cells
  • whole blood
  • white blood cells
  • platelets
  • fresh frozen plasma
  • cryoprecipitate
  • immunoglobulin preparations
  • bone marrow or stem cells from a donor other than yourself

Other factors that raise risk for hepatitis B and C include:

  • receiving blood clotting factor made before 1987
  • having a solid organ transplants before 1993
  • receiving kidney dialysis for at least several months
  • shooting or snorting drugs
  • body piercing, tattoos
  • sharing razors, nail clippers, or toothbrushes with someone who has hepatitis
  • workplace exposure to blood and body fluids
  • high-risk sexual activity, such as having many sexual partners and not using a condom)

Should I Be Checked for Hepatitis?

Survivors who are at risk for hepatitis B or C should have blood tests to check for hepatitis virus infection.

What If I Have Hepatitis?

If your hepatitis infection doesn't resolve, see a liver specialist (hepotologist) for evaluation and possible treatment. In addition, follow these tips to help prevent further liver damage:

  • Tell your health care providers about all over-the-counter medicine, herbs, and supplements that you take.
  • Don't drink alcohol.
  • Avoid over-the-counter pain or fever medicine that has acetaminophen (such as Tylenol® or “aspirin-free” products).
  • Talk with your doctor about getting vaccinated against hepatitis A and B.
  • Review your hepatitis status with your healthcare providers, including your obstetrician and child's pediatrician if you are pregnant.

To prevent spreading hepatitis B or C to others:

  • Don't let your blood or body fluids come in direct contact with other people.
  • Clean any spilled blood or body fluids with bleach.
  • Cover cuts and open sores.
  • Don't share sharp personal objects, such as razors, toothbrushes, nail clippers, ear or body rings, or any object that may come in contact with blood.
  • Use only new sterile needles for body piercing, injections, tattoos, or acupuncture. Never share needles.
  • Make sure all close household members and sexual partners are screened for hepatitis B and have them talk with their doctors about getting the hepatitis B vaccine.
  • If you are sexually active, use condoms during intimate sexual contact and ask your doctor if your partner should be tested for hepatitis C.

What Can I Do to Keep My Liver Healthy?

You can help lower your risk for liver problems by keeping a healthy lifestyle, such as:

  • Drinking plenty of water.
  • Eating a well-balanced, high-fiber diet. Cut back on fatty, salty, smoked, and cured food.
  • Taking your medicine only as prescribed.
  • Not mixing drugs and alcohol.
  • Avoiding illegal drugs.
  • Checking with your doctor before starting any new over-the-counter medicine, herb, or supplement.
  • Avoiding exposure to chemicals that can be harmful to the liver, such as paint thinner and aerosol cleaners. If you must use them, wear a mask and gloves and work in an area that is ventilated well.

For more information about your liver and how to keep it healthy, read the related "Liver Health after Childhood Cancer."

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