Dear Doctor: My doctor recommends that I be tested for hepatitis C, and I've also seen commercials urging people to get tested for the virus -- but I have no risk factors. Is it really necessary to get tested for it?

Dear Reader: The majority of people who become acutely infected with hepatitis C will not have any symptoms. Of people who acquire the infection, 15 percent to 45 percent will clear it on their own; that is, their immune system will ward off the virus. However, anywhere from 55 percent to 85 percent of patients will develop a chronic infection and a chronic inflammation of the liver. Many of them won't have symptoms until the chronic infection leads to cirrhosis of the liver. That development can occur more than 20 years after the onset of infection.

New cases of hepatitis C are rare, with only 0.3 per 100,000 individuals, and are largely caused by injecting drugs via a needle used by someone with the virus. This practice was most common in the 1960s, '70s and '80s, and those at most risk were born between 1945 and 1965.

Based on this data, a 2012 Morbidity and Mortality Weekly Report (MMWR) from the Centers for Disease Control and Prevention recommended a one-time testing for hepatitis C for those born in the United States between 1945 and 1965, saying that it would reduce death rates and liver cancer rates from the disease.

In years past, treatment of hepatitis C consisted of interferon-based therapy. This type of therapy was poorly tolerated by patients, with horrible side effects from the drug, and it cured patients only 45 percent of the time. New antiviral therapies for hepatitis C do not contain interferon and are well-tolerated. They are simple to take, with once-a-day dosing for 12 weeks and cure rates of 90 to 100 percent.

But the cost of the treatment is exorbitant. One 12-week course costs $94,500; another course of treatment costs $84,000. Due to the costs, insurers will not cover these medications unless there is some form of liver inflammation.

Now think about the population of people born between 1945 and 1965. These patients are between 52 and 72, and many of those at high risk have already seen a doctor and had multiple liver tests. The likelihood of them being newly diagnosed with hepatitis C is low, and the likelihood that the infection will lead to cirrhosis or liver cancer if liver enzymes have been persistently normal is similarly low. By screening people who have little risk of the complications of hepatitis C, we will be diagnosing more people without allowing them to get treatment.

Because of that, the focus on hepatitis C screening should be on those with high risk of infection and a high likelihood of transmitting hepatitis C to others. With injection drug use increasing in this country, this population needs to be actively screened.

If you've been seeing a doctor regularly, have had no previous risk factors and are not at a high risk of new infection, there may be no need to be screened for hepatitis C.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: It has been six weeks since my husband, who is 57, had a heart attack, and I'm afraid he's depressed. His doctors say he's doing really well, but he's getting more quiet and withdrawn. How can we help him?

Dear Reader: Depression following a heart attack is not uncommon. Up to one-third of people who have had a heart attack report symptoms of depression. It's not just the body that suffers the effects of a heart attack -- there can be a mental and emotional toll as well.

A person who goes through a life-changing medical event -- and a heart attack certainly qualifies -- often faces an emotional struggle once the initial danger is past. He or she can wind up feeling alone, frightened and fundamentally different from everyone around them. Even when surrounded by a loving family and caring friends, these feelings of isolation can be profound.

The first challenge is to recognize that something is wrong.

In addition to becoming quiet and withdrawn, symptoms of depression include anxiety, persistent feelings of sadness, problems with concentration, and a lack of interest in the people and activities that were once important. There may be changes in appetite or in eating habits, as well as changes in sleep patterns, whether insomnia or sleeping too much.

One danger posed by depression is that heart patients may not fully engage in their recovery. They may not be careful to always take their medications, and may either put off or refuse to make the lifestyle changes recommended by their doctors. Studies have shown that individuals who are depressed may be twice as likely to have another heart attack.

The most effective treatments for post-heart attack depression are anti-depressants and seeing a therapist, such as a psychologist or psychiatrist. Anti-depressants can ease the burden of the difficult feelings that have derailed the patient's journey back to normal daily life. And in talk therapy, patients can safely explore their fears, pinpoint their anxieties, and gain an understanding of the many ways that surviving a heart attack has reshaped their lives.

If your husband isn't interested in the one-on-one environment of a therapist's office, then a support group is a good alternative. The chance to meet other heart patients and to hear their stories and to share his own can go a long way toward piercing the wall of isolation.

Another excellent avenue of support is something called cardiac rehabilitation. It's a highly structured program, usually 36 weeks long, that includes exercise, education and counseling, all done under careful medical supervision.

The cardiac rehab team typically consists not only of doctors and nurses, but also dietitians, exercise physiologists and other professionals. Participants attend classes and lectures, get important information about the medications they are taking and learn how to return to their daily lives.

Most of all, I suggest talking to your family doctor, who can help you with whichever path your husband is willing to pursue.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: Can olive oil be used topically to aid healing?

Dear Reader: Olive oil has been used since ancient times as a cosmetic and to aid skin healing. The ancient Egyptians used it as an anti-wrinkle potion; the Romans used it as a moisturizer after bathing. To this day, olive oil is used widely in many countries to treat and prevent multiple skin conditions.

Now let's look at the evidence.

The purported benefit of olive oil may come from its fatty acid composition, predominantly oleic acid, but also palmitic acid and linoleic acid. These fatty acids have been thought to have both anti-fungal and anti-bacterial properties.

Oleic acid, a monounsaturated fat, has been shown to penetrate the upper layers of skin, where it permeates between the cells -- seeming to suggest that it's an effective moisturizer. Anecdotal evidence might seem to bear that out, but note that oleic acid has been found to actually increase water loss across the epidermis, countering the notion that it can help lock in the skin's moisture.

In a 2013 study published in the journal Pediatric Dermatology, researchers studied volunteers who applied six drops of olive oil to their forearm twice daily for five weeks. They found that the skin treated with olive oil not only lost water, it also experienced a reduction in skin thickness and integrity, and in some people caused a local reaction. The authors surmised that olive oil's disruption of the skin may allow for penetration of allergens and increased inflammation of the skin's layers.

Some people use olive oil in an attempt to mitigate stretch marks induced by pregnancy. The evidence for that is sketchy as well. In a 2012 study published in Complementary Therapies in Medicine, 50 women who were 18 to 20 weeks pregnant applied olive oil twice daily to their abdominal skin, massaging it in gently each time, keeping this practice up until they had delivered their baby. A control group of 50 women applied nothing to their abdominal skin. Although researchers did find some decrease in severe stretch marks among those who used olive oil topically, they found no overall significant difference in stretch marks between women who used olive oil and those who didn't.

One place where olive oil may hold potential is in its treatment of diabetic foot ulcers. A 2015 study published in the Journal of Diabetes and Metabolic Disorders showed a significant improvement of healing and shrinking of ulcers with use of olive oil among people with grade 1 or grade 2 diabetic ulcers (the least serious of the grades, which progress to grade 5). Complete ulcer healing occurred after 4 weeks in 73.3 percent of those who had olive oil placed over the ulcer versus 13.3 percent who didn't. This healing may be related to olive oil's potential to dry the lesion, which is linked to its propensity to remove water from the skin.

As for other skin conditions, some case reports have suggested that olive oil may reduce acne and symptoms of impetigo, but no controlled studies have been done.

So the evidence for olive oil on its own as a topical agent is not convincing. Further, it may even cause skin irritation, so I wouldn't recommend it as a moisturizer, especially for infants. But because of olive oil's ability to penetrate the skin, it could potentially be helpful in combination with another agent. As for its potential in healing skin ulcerations in the lower legs and feet, further study is needed.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)