Adoptive Parents Discuss Hepatitis B

Quotes from parents and agencies on the Adoptive Parents of Vietnam (APV) mailing list are provided to present Hepatitis B infection in the context of adoptive families. If you are in the process of making a decision in regards to Hepatitis B, please consult your pediatrician and refer to the Hepatitis B resources page for more information.

• Our Son Tested Positive For Hepatitis B
• Things To Consider About Hepatitis B Testing And Adoption
• A Well Known Agency's Experience With Hepatitis B and Asian Adoptions

Our Son Tested Positive For Hepatitis B
Trish, adoptive mother of two children from Vietnam

When we accepted our referral from Vietnam, we asked if our son had been tested for Hep B and HIV.  We were told he had not been and would not be, but that most kids are not infected.  We knew nothing about HepB except that it occured in Vietnam.  Five days after we arrived home, our pediatrician called to tell me that our son had tested positive for HepB. The results showed that he had cleared the infection, but was a 'latent carrier'.

I didn't take the news well.  I was scared to death, to put it mildly.  I knew nothing about Hep B and had seen it mentioned only in relation to HIV, which I equated it with.  I was petrified that our bio daughter had contracted it from him.  I cried for days.  Then I decided to educate myself.

I called the Hep B and Liver Foundation and talked with experienced professionals.  What I found out was very reassuring.  The only things Hep B has in common with AIDS is route of transmission.  That was a big relief. As a latent (carrier with no active disease) carrier, my son has a normal life expectency.  Our whole family is protected by a vaccine, and transmission to others can be controlled by using universal precautions. Although his condition requires education and will restrict his intake of alcohol in adulthood, it does not interfere with his life in a major way. 

If we had been educated about HepB before our adoption, we would have handled the news in a much calmer way.  I encourage all parents to read and talk to your doctor about Hep B.  HepB is not the common cold, but neither is it a death sentence.  With the proper medical attention, most children with Hep B will live long, happy lives. 

I know that hepatitis B is a scary thought, especially when you're expecting your first child, or adopting for the first time.  And it's certainly not a trivial problem;  the virus can cause liver damage, it can increase the child's chance of liver cancer later, and there are cases in which a child can become a carrier of the virus, and transmit it to others later, even when the child is perfectly well.

But let me suggest some other ways to think about it.  First, to say that something CAN cause a problem doesn't mean that it WILL;  lots of people live long, healthy lives after having had hepatitis B.  We're simply talking about increased probabilities, which can result from all kinds of other conditions as well, not about a certainty.  There's not much reason to worry about your child being a carrier;  you and the rest of your family can (and should) be vaccinated against hep B anyway.  It's a series of three shots over a six-month period, and if you want to feel reassured that you're protected, you can be tested at the end of that time to make sure that the vaccine has left you with antibodies against the virus.  A child who's a carrier won't be discriminated against in school, because no one is required to tell the school that a child tests positive for hepatitis, and if you decide to tell the school, it is prohibited from releasing the information.  School personnel are supposed to use universal precautions, such as using gloves when dealing with an injury involving bodily fluids.

And I hope this doesn't sound discouraging, but I think sometimes the existence of tests such as these gives us the impression that we have a lot more control over our children's lives than we actually do.  These little folks don't come with warrantees, whether we grow them or adopt them, and we soon find that in either case, we can be faced with unexpectedly wonderful events or much more trying events, no matter how much careful planning and testing we do.  It may be that a baby who tests
positive for hepatitis B may resolve the infection later and may turn out to be the warmest, brightest child imaginable, or that a child who tests negative could later be hit with something more worrisome.  So I'd suggest to those of you who are just starting this process that a positive hep B test is certainly worth thinking about, but it probably shouldn't be sufficient in itself to lead you to stop considering a particular child. 

However, I feel uncomfortable giving direct encouragement to anyone because my husband and I have not adopted a child who tests positive, so my encouragement can only be theoretical, and I don't think that's sufficient for someone actually facing the choice!

Our agency has had a 1% incidence of Hep. B among the Asian children we have placed in adoption.  The testing is unfortunately not reliable, not in Vietnam and not even in the USA.  We have had false positives and false negatives in both countries. 

Of the three cases we have had in nearly 400 adoptions, one child's Hepatitis B vanished of its own accord within a year. The advice we hear for the other two is treat the child normally in every respect, and to follow up with a doctor who will perform a test for liver function once a year.

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