DEAR DR. DONOHUE: I have chronic hepatitis C. My understanding is that anyone with chronic hepatitis C should get treatment. A doctor told me that patients are not treated until they get liver cirrhosis. It seems to me that a patient would have a better chance of recovery if treatment were given early. Will you give your opinion on this? – I.C.

ANSWER: Nearly 75 percent of people infected with the hepatitis C virus will come down with a chronic liver infection. That means the virus will stay in the liver forever. After 20 years of liver infection, 20 percent to 30 percent of the chronically infected develop liver cirrhosis. Cirrhosis is a scarred, nonfunctioning liver.

Today’s medicines have revolutionized hepatitis C treatment. The combination of interferon and ribavirin can bring the number of hepatitis viruses in the body to undetectable levels in more than half of those who get treatment. That doesn’t say positively that treatment cures these people, but it is a way of suggesting that they might be cured.

Should everyone with chronic hepatitis C infection be treated? No. Some will not progress to cirrhosis, and treatment can have undesirable side effects. Treatment is given to those who are at an increased risk of progressing to cirrhosis. Indications of potential progression include elevations of blood levels of liver enzymes, demonstration that the hepatitis C virus is circulating in the blood, and biopsy evidence that the liver shows strands of scar tissue or inflammation. Treatment is not delayed until liver cirrhosis has occurred.

DEAR DR. DONOHUE: Some time ago you discussed nighttime leg cramps and mentioned that quinine is no longer available for treatment. Not quite so. Tonic water has quinine in it. There are no restrictions on buying it.

My late husband and I both suffered from leg cramps at night. We found that tonic water worked quickly. I still drink it. I have found it to be a perfect solution. Hope you find this information useful. – N.L.

ANSWER: Thanks to you and to many others who wrote about the effectiveness of tonic water in quelling nighttime leg cramps.

Tonic water does contain quinine, but the amount is much less than the amount in quinine capsules, a popular remedy for leg muscle cramps. Those capsules were taken off the market because they failed to demonstrate a level of effectiveness that could justify their possible side effects. They are still available, however, with a prescription.

If people wish to try tonic water, there’s no reason not to. Not everyone is going to meet with rousing success.

I want to thank the many readers who wrote to me with their favorite leg cramp cures. They included calcium, magnesium, potassium and vitamin E. Some testify to the efficacy of pinching the skin between the upper lip and the nose to quickly terminate a cramp. I have tried this, and it works – sometimes. Others sing the praises of soap. They tell me that putting a bar of soap under the blankets prevents nocturnal cramps. I have mentioned this in the past, and many have responded that they have gained cramp-free nights with the soap remedy. The soap can be wrapped or unwrapped, and the brand doesn’t matter.

Keep the remedies coming. Some day I’ll print all of them.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.