Dear Alice,

My brother has Hepatitis C. He is having problems with water retention and has holes in his kidneys. How should Hep C be treated and how should the damage to his body be treated? Can we protect ourselves? Need help.


Dear DB,

Your concerns about Hepatitis C are important and primarily need to be answered by your brother's medical provider(s). When a family member is diagnosed with a long-term disease or condition, families can often make appointments to see the primary care provider and/or specialist and/or team. The only prerequisite for this kind of family meeting is that your brother would need to provide consent to the medical team. During this kind of informational meeting, medical condition(s), treatments, and/or precautions that families need to know or take are described and explained. At the same time, any family member(s) has an opportunity to ask questions, raise issues, voice concerns, and clarify information. Because the entire family, or those in attendance, hears the same information, they can discuss the situation from a position of confidence acquired from knowledge rather than fear from insufficient information.

Go Ask Alice! can answer general questions, but a family meeting with the medical provider(s) not only gives individualized information and manages concerns, but also diffuses anxiety and strengthens communication within the family, allowing for support and greater quality care.

Hepatitis C is a viral infection predominantly spread through contact with an infected person's blood. As such, it is usually contracted through shared needles with an infected person, unprotected sex with an infected partner, or through contaminated blood transfusions before 1992, when not all blood was tested for the Hep C virus. The prevalence of Hepatitis C in the general population of the United States is just under 2 percent. Rarely, family members can become infected, so it is important not to share things such as toothbrushes. Usual expressions of affection between family members, such as hugging and holding hands, have no associated risk. Sexual transmission is also rare, but it does occur.

People who have been infected with Hep C often go years, even decades, before they develop symptoms of the infection. That's why it is important for people with risk factors for Hep C (such as those mentioned in the above paragraph) to get tested. Early signs and symptoms of Hep C are:

  • fatigue
  • mild right-upper-quadrant discomfort or tenderness ("liver pain")
  • nausea
  • poor appetite
  • muscle and joint pains

Later, when liver damage from the Hep C virus has occurred, a person can develop:

  • jaundice (yellowish skin)
  • muscle weakness
  • decreased appetite
  • weight loss
  • itching
  • dark urine
  • fluid retention
  • abdominal pain/bloating

Ultimately, between 20 - 50 percent of people with Hep C will develop cirrhosis — chronic, usually irreversible liver damage. Again, though, this typically takes 10 - 20 years to develop. In the most severe Hep C cases, a person may require a liver transplant.

People with Hep C need to maintain the health of their liver because its function is to help digest food, filter drugs and toxins, and store vitamins and minerals. In people with liver disease due to Hep C, it is also possible to develop kidney problems. This is usually something you do not see until later in the course of the illness.

A person with Hep C can help decrease symptoms and prevent further organ damage by:

  • avoiding ALL alcohol;
  • getting vaccinated against Hepatitis A and B;
  • taking antiviral drugs prescribed by his/her health care provider (typically for a period of 48 weeks);
  • using certain herbal products and multivitamins cautiously and under direction from his/her health care provider;
  • checking with his/her health care provider before taking painkillers;
  • eating more healthfully by:
    • limiting salt intake
    • choosing lower fat foods
    • eating plenty of grains, fruits, and vegetables
    • drinking 6 to 8 eight-fluid ounce glasses of liquid daily; and,
  • exercising moderately, 3 - 4 times a week.

Depending on one's pre-existing condition(s), for example, if extensive liver damage has already occurred, and how quickly therapy is started, research shows that taking a combination of high-dose oral antiviral medications reduces Hep C viral loads to the point of being virtually eliminated. The downside is that this therapy can cause serious side effects, such as acute anemia, personality changes, depression, and even psychosis. As a result, a decision(s) needs to be made concerning an individual's course of treatment.

Hep C is diagnosed through a simple blood test, which can be requested. Blood is drawn during an annual exam to test for the virus. Although no vaccine or absolute cure for Hep C currently exists, avoiding risky behaviors can help protect against getting Hep C, including:

  • not sharing needles or drug-related equipment
  • wearing latex gloves when in contact with someone else's blood
  • using condoms when having sex outside of a committed, monogamous relationship
  • ensuring that fresh needles and sterile equipment are used while being tattooed

In order to help stop its spread, people with Hep C need to be frank, open, and honest about their condition with sexual partners and in situations where blood might be exchanged. Developing trusting, ongoing relationships with health care providers can also help people manage their condition.

With a proactive, positive approach to keeping the body healthy, and depending on the infection's course, a person living with Hepatitis C can experience a full, and fulfilling, life.

If you want to know more information or learn how to share information with the people important to you, you can make an appointment with your primary care provider; if you are at Columbia, you can call Health Services at Columbia at x4-7426 to schedule a visit. You can also check out the American Liver Foundation website.


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