P35.3

Clinical Causes: Mother infected with hepatitis B virus (HBV) or hepatitis C virus (HCV) passing the virus to the fetus during pregnancy. Transmission of hepatitis viruses through childbirth, especially if the mother is actively infected at the time of delivery. Breastfeeding from a mother infected with hepatitis viruses, although this is less common and depends on the type of virus and presence of maternal blood or other fluids.

Key Symptoms: Jaundice (yellowing of the skin and eyes) Poor feeding or difficulty feeding in newborns Lethargy or signs of fatigue Abdominal swelling or tenderness Dark urine and pale stool Poor weight gain or failure to thrive Irritability or unexplained fussiness

Diagnosis Path: Diagnosis of congenital viral hepatitis involves a combination of medical history review and laboratory testing. Key approaches include: - Blood tests to detect hepatitis virus antigens and antibodies in the infant, such as hepatitis B surface antigen (HBsAg) or hepatitis C antibody. - Polymerase chain reaction (PCR) testing to identify viral DNA or RNA, confirming active infection. - Liver function tests to assess the extent of liver inflammation or damage. - Screening of the mother for hepatitis B and C viruses, to understand the risk of vertical transmission. - Imaging studies like ultrasound, which may reveal liver swelling or other abnormalities.

Treatment Protocols: Treatment of congenital viral hepatitis depends on the specific virus involved and the severity of the infection. General management strategies include: - Antiviral medications may be prescribed in some cases, especially for hepatitis B, to help control the infection. - Supportive care to alleviate symptoms, such as medications for jaundice and ensuring adequate nutritional intake. - Regular monitoring of liver function and viral load to assess disease progression. - In cases of hepatitis B, vaccination and post-exposure prophylaxis for the newborn can help prevent disease progression. - For severe cases, especially where liver damage is significant, advanced interventions such as liver support or transplantation may be considered. Early diagnosis and tailored management are vital in minimizing long-term complications and supporting the child's health.