Hi Vororo,

The fully disposable syringe was invented by Colin Murdoch, a New Zealand pharmacist, in the year I was born (1956). Obviously it took a while after that to come into common let alone universal use. I have early childhood memories of GP inoculations being given by syringes that were shiny and “clinked” when returned to the little metal tray they used and just the fact that they put it back on the tray would indicate it probably wasn’t disposable. This occurred prior to migrating from UK to Aust so very early sixties when I was maybe 3-6 yr old?

Having said that and while it doesn’t matter much anyway, I can state that I’m a gentle soul and with conviction that it isn’t possible that I contracted HCV from method (b), which leaves (a) unless (d) applies.

There are also some interesting studies of how it appears to have spread outwards into the community from Glasgow hospitals post WW2.

So while I suspect us BBs have caused some interesting patterns and swirls in the dissemination of HCV, the research does seem to indicate that the greatest spread has occurred due to knowledge/technology/military issues rather than allegedly “moral” ones.

Good deduction there Mike, so how did the various genotypes come about? Just asking cause that area always confuses me.

Okay, so I’ll try and give this a go from an evolutionary genetics perspective:

As Vororo says HCV has been around for a long time. Basically we probably started out with either one (or possibly a very few) strain of HCV which crossed the barrier from some other host into the human population. Viruses don’t breed though so they basically replicate themselves with each generation being the same as the previous one.

The exception to this rule is when they mutate into something different but in almost all cases the mutation will be weaker than the original strain and won’t be as successful at replicating so will die out or be killed off by its hosts immune system ending that new strain before it has a chance to spread into other hosts. But very, very occasionally the mutation will be successful. It will be good at replicating itself accurately and may have an advantage over the original in how it manages to evade our immune system. So it will continue to thrive and may get lucky enough to spread into other peoples bloodstreams. If it does that often enough then that strain will likely continue into the future as a new genotype or subtype. Now, the chances of genotype 1b mutating into 3a are so infinitesimally small that basically “it ain’t gonna happen!”. But what will happen is that 1a will become 1ax or 1ay or if it is different enough it will create a new genotype, say GT8 or whatever we decide to call it.

Here you have to remember that because HCV is only spread by blood to blood contact it has a linear transmission path so in ancient times you would find that all the people infected in an area would have the same or similar genotypes/subtypes. Until you throw in population movement, migration and now modern jet travel, etc. then we start to get a mix of types across the world.

Below is a great picture that shows the main genotypes by their place of origin/greatest commonality. The interesting thing to note is that while there are 7 main genotypes there are many, many more subtypes. Some of these subtypes have or will die out, other new ones will be created. This is a bit like human genetics in that there are people who are blue eyed, and of these some will have blonde hair. So we have blue eyed/blondes but even within this grouping there will be some with straight hair, some with wavy hair, some with curly hair and some with frizzy hair. Each of the Geno-subtypes is a bit like that. But to keep things simple and because all the genotype 1a subtypes are very similar, we just say they are 1a. (Or blue eyed/blondes).

Hopefully all that makes sense as a very simplistic explanation. Please discuss amongst yourselves and there will be a test in the morning.

Here you have to remember that because HCV is only spread by blood to blood contact it has a linear transmission path so in ancient times you would find that all the people infected in an area would have the same or similar genotypes/subtypes. Until you throw in population movement, migration and now modern jet travel, etc. then we start to get a mix of types across the world.
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Very good analogy of how things came about. So if its been around since ancient times, how has that been determined? Have mummys been found to have HepC?

Thanks beaches, this year the festivities fall just after EOT so there will be much (low carb) feasting but rather limited sacraments.

Yes V, I remember lining up for TB vaccinations at school. Australia in the 1960s.

As for stigma, I had an ugly experience yesterday at the chemist. I was there with my elderly mother who was filling a script. It’s a busy pharmacy adjacent to a busy bulk-billing (ie free) medical clinic on the border of Queensland and NSW.

While waiting I heard the senior pharmacist complaining to another elderly customer about the new Hep C medications. How they cost her $22,000 for each 12 week treatment. How she refuses to stock them. How ‘they’ don’t deserve to get medication on the PBS when ‘they’ are responsible for getting Hep C in the first place.

I was dumbstruck. I didn’t expect to hear such malicious misinformation from a health professional, or in such a public way.

So I took her aside and let her know I strongly disagreed with her views. How for a start not everyone with Hep C got it from using drugs (the faces of Lynne and Tina helped me along here, as I tried to shove my own guilt aside). How the new meds are saving lives.

Her response was about how much her husband’s cancer and chemo treatment are costing, while ‘those drug addicts at Mirikai’ (a Gold Coast rehab) pay only $6.20. I didn’t think to say sorry about your husband. Maybe that would have softened this stressed out, angry and intolerant person. Or not…

Instead I pointed out that her attitude is discriminatory, and exited with ‘someone in your position should know better than to mouth off like that’. My blood was boiling.

Do I take this further? Name and shame? Complain to the Health Care Complaints Commission? Or let it go as another sad example of human ignorance?

To remove the stigma of Hep C, perhaps we need to remove Hep C.