[lovemybulldog]

We are planning to adopt a SN child from China. We have yet to review medicals, but there are a few I might consider who have a positive Hep B diagnosis. Can anyone share info or advice about Hep B? I know there are different severities, but is this something that can be resolved with treatment or is it one of those things that can/will have residual problems?

Thank you!

[angelkisses0102]

I *think* some families in the Russian forum may be able to help you on this...try posting it there.

Good luck.

[sak9645]

I'm not a physician, and my daughter does NOT have Hep. B, but here is my understanding of the situation.

When people are infected with Hep. B, some will experience a complete recovery and NOT become chronic carriers. However, many will become chronic carriers. You can tell by good lab testing whether a person has become a chronic carrier.

Also, if a baby has a mother who is a chronic carrier, he/she may test positive for Hep. B, even if he/she is actually negative, up to around age two, because of maternal antibodies. If a country, like China, refers a child under two in the special needs program, because of Hep. B, there is at least some chance that further testing, once the child is home, will show that he/she is actually negative.

All chronic carriers can infect any person who has not received effective immunization against Hep. B. Hep. B, however, is transmitted only in blood and other bodily fluids. It is not transmitted by casual contact or through the air. And some bodily fluids are more likely to transmit the disease than others. As an example, contact with saliva carries less risk than contact with blood.

The good news is that most American children are immunized against Hep. B. In fact, some states require immunization for admission to schools, day care centers, etc., unless a family has a religious objection to vaccination. Some day care centers require immunization against Hep. B for their staff, and most health care personnel are also required to be immunized.

As a result, the likelihood that a child who is a carrier will infect someone his/her age is low. However, it is important for a parent to educate family and caregivers about the importance of using "universal precautions" to avoid contact with blood and bodily fluids, and of being immunized.

Children who are carriers also need to be educated as they get older and do more things on their own. As an example, an older child should be taught what to do (or tell a friend's parent to do) if he/she gets a bad cut while playing at a friend's house, and blood gets on the floor. (This includes keeping friends away from the blood, using a dilute bleach solution to clean the floor, etc.)

Before a carrier becomes sexually active, he/she should be taught about the importance of "safe sex", since Hep. B can be transmitted sexually. A female carrier needs to be told that it might be advisable to avoid pregnancy, lest she infect her baby during the birth process, and to consider forming her family by adoption.

Some chronic carriers will not show any symptoms of Hepatitis B, despite being infectious. Their life span may be normal, and there may be no liver damage. They will simply have to be monitored to ensure that no liver problems occur over time. A doctor may advise them not to do things that stress the liver, such as drinking alcohol or taking certain medications, such as acetaminophen.

Some chronic carriers may have liver problems that will arise only when they are in middle age or old age. Hep. B can predispose a person to the risk of liver cancer or cirrhosis of the liver. Again, any Hep. B carrier should be monitored regularly to ensure that no liver involvement is occurring. Many doctors believe that, by the time a baby who is born today reaches middle age, a full cure for Hep. B will be found and complications will not occur.

Some people with Hep. B WILL have liver damage that starts early in life. There is no actual "cure" for Hep. B. However, some of the treatments that exist currently can reduce viral "load" to low levels and minimize the possibility of severe damage to the liver.

Testing of newer, and possibly more effective, treatments is under way. Working with a competent specialist in infectious diseases will be important.

A family adopting a Hep. B positive child will need to have access to excellent medical care resources in his/her community, in case ongoing care is needed.

A family adopting a Hep. B positive child should also have group health insurance, subject to HIPAA protections, that will cover a child with special needs. Any insurance policy that is obtained should allow for the coverage of treatment with the sort of antiviral drugs, such as interferon, that may be necessary in some cases.

A family adopting a Hep. B positive child should be aware that delicate questions about whom to inform will arise. The family will have to strike a balance between protecting others from getting Hep. B and protecting the child's right not to be stigmatized because of his/her condition.

There are several Internet sites where one can learn a great deal about Hep. B. Here are just a few:

1. The Centers for Disease Control (Centers for Disease Control and Prevention)
2. The Hepatitis B Foundation (Hepatitis B Foundation)
3. The Hepatitis Foundation International (Hepatitis Foundation International - Hepatitis Living and Learning Resources, Support and Answers)


Sharon

Sharon

[Karen in MT]

Thank you. We too are considering adopting a Hep-B child. -Karen

[overthefence]

Hello! I am an adoptive mom to a daughter who has chronic Hepatitis B.

I was curious when I read in one of the previous comment: "A female carrier needs to be told that it might be advisable to avoid pregnancy, lest she infect her baby during the birth process, and to consider forming her family by adoption."

I had never heard that before as there is a vaccine if given at birth that keeps the child from acquiring the disease in 90% - 95% of cases.

(Immunization Action Coalition: "Ninety percent of perinatal infections can be prevented by postexposure prophylaxis given within 12 hours of birth." Unprotected Babies: Hepatitis B Vaccine at Birth Saves Lives!)

(Hepatitis B Foundation: "If a pregnant woman tests positive for hepatitis B, her newborn child must be given two shots in the delivery room - the first dose of
hepatitis B vaccine and one dose of hepatitis B immune globulin (HBIG). If these two medications are given correctly within the first 12 hours of life, a newborn has a 95% chance of being protected against a lifelong hepatitis B infection." http://www.hepb.org/pdf/pregnancy.pdf)

At Maryland Department of Health's website:
"Pregnant women who are hepatitis B carriers should tell their doctor about their infection. It will be important to give the new baby shots soon after it is born to protect it from getting hepatitis B. It is okay to breastfeed if the baby is getting shots to protect it from hepatitis B."
(Hepatitis B Carrier Fact Sheet)

And at the Centers for Disease Control:
"Hepatitis B shots protect you from HBV --3 shots are needed for complete protection.
Your children should start hepatitis B shots as soon as they are born.
If you have HBV in your blood, your child will need a shot called HBIG along with the first hepatitis B shot within 12 hours of birth."
(Protect Your Baby With Hepatitis B Shots)

If I have missed a particular instance in which a chronic carrier would be asked not to reproduce, I would appreciate knowing that information.

[sak9645]

Remember that five to ten percent of children born to Hep. B carriers, who receive the vaccine at birth, will not be protected against the disease. For many couples, that is NOT an acceptable risk.

Sharon