hepatitus c -- need help, info, guidance

[elis-w]

  a relative of mine has been diagnosed w/ hep c.  she is afraid of seeking treatment for fear of insurance denial for her 2 infant children.  currently, her liver is inflamed, and she has appeared to be somewhat jaundiced recently.  she also drinks alcohol 3 or 4 times per week.  what can i tell her?  how dangerous is her condition?  is her family at risk?  please help.

[HFHSM.D.-D.M.]

_
Dear ellis w.:
You ask a series of questions all of which are excellent.  Let me try to address all of them though not necessarily in the same order.
First of all you ask how dangerous is your friend’s condition.  I can’t answer that specifically but that is an important point in itself.  Hepatitis C comes in many different flavors.  One individual with hepatitis C can have little to no damage to the liver whereas someone else can have a failing liver and need liver transplant.  Your friend is going to need a complete evaluation at some point.  If she does have jaundice, this is extremely concerning and she is going to need to receive care soon.  Moreover, your friend’s use of alcohol is potentially a disaster.  We know with certainty that significant alcohol use will accelerate the damage from hepatitis C.  Your friend needs to stop immediately and completely until things are sorted out.  Again, if she does have jaundice, this is even more urgent.  
I appreciate your questions about the risk to the family. This issue is a great source of tension for many individuals with hepatitis C.  Transmission of hepatitis C requires blood to blood contact.  It cannot be spread through casual contact.  The only way her children would be at risk is if your friend was infected at the time she was pregnant with her children.    
Transmission of the virus from mother to infant is during pregnancy unusual but it is possible.  A number of series have been published and it appears that the risk of transmission is probably in the range to 2 to 5%.  The transmission takes place either prior to birth or at the time of birth.  The rate of transmission appears to be higher in women who also have HIV/AIDS.  We often do recommend that women with hepatitis C have their children tested if they may have been infected when they were pregnant.
Good luck to your friend.  Jaundice is always a very serious development.  I hope this information is helpful to you.  If you have additional information or questions, I would invite you to post the material to MEDHELP or to contact us directly at Henry Ford [phone]. We have an active group of liver specialists and we have a strong interest in the care and research of hepatitis C.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation.  Always check with your personal physician when you have a question pertaining to your health.