Health : Hepatitis C: The New Plague?
Being somewhat of an online regular, I like to check out areas that I have visited or hope to visit someday. I’ll look at cities in the U.S. and other parts of the world to see what the men there are like and how they present themselves. One thing I’ve noticed recently was that in some cities in Europe men have begun posting their most recent test dates for Hepatitis C. Here in the U.S., we’ve all become accustomed to seeing men post their last HIV test, but I found the Hep C postings a little strange. I decided to do some research and have come up with some disturbing information. Allow me to pass some of it on because I don’t see it becoming mainstream news. And it should, because it strikes me as oddly familiar with how HIV was dealt with (or not) in the early 1980s.
Hepatitis C is a blood-borne infection that can be passed by as many ways that people can come into contact with other peoples’ blood. It attacks the liver and over time can cause enough damage to make the liver completely unusable by the body, leading to death. There is no cure, and any vaccine is years away from approval. Sexual contact has not yet been entirely ruled out as a possible route of transmission. The most certain way of catching Hep C is by sharing needles if shooting up drugs.
So you may be asking yourself what this has to do with you. You don’t shoot up drugs and you don’t have rough sex that creates any cuts anywhere (that you know of). Perhaps you don’t, but there are many, many men that have and do. The Hepatitis C virus can remain virulent for up to four days on a drop of blood outside the body, even dried. It only requires one time exposure to become infected with Hepatitis C. Let me repeat that: one time exposure. Many times the virus is asymptomatic (meaning there aren’t any outward signs to make someone think they are sick) for years before it is discovered. So let’s say you may never have gotten into the party spirit and never thought you might just try injecting a drug just one time. I am here to tell you that plenty of other men have. That one time lapse in judgment isn’t something people usually admit to on a first, second, or even a third date. Would the subject even come up in normal conversation?
Sharing needles isn’t necessarily the only way to become infected. Sharing other items that may seem harmless such as a razor or even a toothbrush will spread the infection. A razor might seem fairly obvious for possible contamination from a nick while shaving. A toothbrush on the other hand, creates many tiny cuts even in the healthiest of mouths. It is important to try to wait at least an hour after brushing your teeth before engaging in sexual activities to give the mouth time to heal those micro cuts. Think about someone that may not be a big fan of regular dental checkups. We are all constantly under attack of periodontal disease wreaking damage to our gums. In that case, there could be more pronounced bleeding in the gums after a brushing.
But what about the underlying issue that has created this Hepatitis C onslaught? Does anybody else think the rising use of crystal meth has any correlation besides me? I’ve noticed more and more profiles of guys that say they like to PNP (Party-N-Play). Smoking meth not only messes up peoples’ heads, but have you seen the havoc it creates to peoples’ mouths? It eats away tooth enamel and destroys gums. Passing a meth pipe might be the same as passing around Hep C at a party. Maybe the best way to help people remain as healthy as possible, if not by avoiding meth, but by practicing some harm reduction and only smoking it from their own personal pipes and not sharing it. The Center for Disease Control doesn’t seem to think Hep C can be passed orally, but I don’t think they take into account the crystal meth angle. What do you think? I’ve included a chart on different forms of Hepatitis and ways they know and think they know how it is passed. Check it out.
Table illustrating the transmission of the various forms of viral hepatitis
Reference: http://www.epidemic.org/theFacts/hepatitisC/transmission
David Beck
oral to fecal, potentially a rim job
Thank you for this important information. I actually think that guys who test neg for the standard stds think they are totally clean when in fact that may not be the case. I see guys with really red dicks all the time who say they are all neg. Perhaps it’s a skin condition, yeast, or something else that might be communicable. I know I’m a lot more careful now giving head as I was always getting sore throats, etc and still do. I also get tested for hep b and c the most common but i don’t think everyone who gets tested for stds does get the hep test, and that’s really important. The only thing I TOTALLY disagree with you about is your kind of halfhazard comment about drug use and using your own pipe when you do meth. Get real! You should never condone meth use period and to make such a statement is really dismissive of the seriousness of such actions and totally irresponsible. Otherwise, a good post.
Good post and research. Agree with Steven and the last comment on Meth but lets not be judgemental. We do a great job in the gay community of judging each other rather than reaching out with empathy. Steven, I also take serious offence to this word CLEAN. We need to scrap it from our vocab when we talk about STI and especially AIDS. Let’s get rid of the stigma and ensure that word is used only where it belongs but not with peoples health. How about STI FREE? STOP THE DISCRIMINATION OF OUR OWN BY NOT USING CLEAN. Does that mean Poz or Hep C are dirty cause they are infected. STOP!
Your reference is about 15 years outdated. There is a cure for hep c, I know because I was fully cured.
I live in st louis and St louis University has one of hte best Liver clinics in the world. Im not saying youd ever want to get hep c or any disease, but people are being cured from the disease and it is being succesfully controlled in others. Please get all the true facts before posting medical information
I couldn’t agree with Steven more. I really commend you for bringing such an important topic to our attention. This may be the only place a lot of guys in our community get such important, life saving medical information and I think this is a valuable and important service that you provide. This information may have already saved thousands in our community from this deadly disease from which there is NO cure! I just can not commend you enough. That being said, I must also agree with Steven on your rather dismissive tone when discussing meth use and other “recreational” drug use. I’m no Pollyanna and I know many gay guys and others in the LGBT community use drugs, however, if you are going to offer life saving health information, you can’t be dismissive of the fact that most, if not all, of these drugs pose a significant risk to our health. These risks include, but are not limited to, cancer, periodontal disease, hepatitis, lung and brain diseases, cardiac disease, and death. Drugs are a major epidemic in America and we owe it to the gay community to need the battle cry and wage war against this insidious scourge that is taking the life of our brothers and sisters. It is not cool to do drugs, intact it is very stupid! I look forward to you addressing this issue in a future health blog. Keep up the good work.
I don’t think Mr. Beck is condoning meth use, he is just being practical. Some users will never stop doing drug and you won’t scare them into stopping with this blog. But now they will be more informed and maybe preventative of the spread. I have never been a drug user, never used meth and the only time I’ve been shot up with a needle has been in my doctors office, so I’m not at all worried about getting the virus that way either. Thank you Mr. Beck for the useful information, I hope people start taking this virus more seriously. I have always wondered how it was spread, but I never thought it would ever effect me, so I never looked it up. Now I know it could, so I’ll do some research on it myself.
Well done to cover the subject, but factually wrong when you state there is no cure, there is a treatment for HepC (Ribavarin/peg-interferon) its not a nice treatment, but for many it works and within one year they are disease free.
Like HIV the real killer is not knowing, meaning not getting tested.. Here in in Western Europe most testing centres now test for HepC by default. To know is to be in control. same goes for HIV and for cancer.. Ignorance is often a death warrant..
The big problem with meth, along with other various party drugs, is that it lowers inhibitions and pain thresholds and increases stamina making unprotected rough hardcore marathon sex much more common, often with multiple partners. Meth also dries out mucus membranes, which are responsible for keeping the tissues in healthy condition — people who use meth and similar drugs, especially alot of it, get dehydrated and are MUCH more susceptible to infection through degraded, dried up or cracked tissues. This means that blood borne diseases can enter the system significantly easier in meth users, which together with the hardcore group sex is a recipie for disaster. So really unless you can get people to stop having unsafe sex while partying the best you can hope for is containment to that segment of the population because there will always be a new drug and a new disease that takes advantage of unsafe behavior.
Thanks for putting this info out there. I didn’t even know there is a Hep D and Hep E!
Steven, if you “see guys with really red dicks all the time” and are still “getting a lot of sore throats”, are you maybe going thru a LOT of sex partners? I do agree it’s a good idea to point out the hazards of meth and other recreational drug use.
tis come sence this artical never rim some one portect you selfs guy that be safe
had hep C.took alpha-interferon for 18 months, almost killed me.No cooties now,all functions are normal.As to smoking meth we all know its poison.I caught hep c at hosp with uncovered needles for taking my blood due to valley fever,anything shared by mouth or snorting is not cool.If u can’t control ur urges about dope then at least use ur own tools…..
hey daniel-you cant get hep c from rimming. i have been rimming for yrs and caught nothing.
I MYSELF HAVE HEPATITIS C GENOTYPE 1A…THE HARDEST TO EVER TREAT.MEN OFTEN WORRY ABOUT HIV AND OTHER STD’S BUT I ALWAYS STRONGLY SUGGEST THEY GET A HEPATITIS PANEL.THOUGH IN MY CASE HEPATITIS C DOESNT EFFECT ME AT ALL I AM SEEKING TREATMENT TO PREVENT FUTURE PROBLEMS.UNLIKE HIV THOUGH IT IS NOT TRANSMITTED SEXUALLY ALTHOUGH YOU SHOULD STILL WEAR A CONDOM.I ALWAYS INFORM MY SEXUAL PARTNERS OF MY HEPATITIS.
To Steven. I agree with you that meth use should not be condoned In any way. However, if this simple tip of not sharing drug utensils can help decrease the spread of hep c then fantastic. And if one meth user sees this post and takes heed then even better. I see no reason for your comment to the author of the post. What are you doing to try and help?
I understand why safer drug practices were mentioned. As a former STD educator it was our responsibility to educate users on ways to protect themselves if they are unable to stop using drugs that may pass on infections.
I’ve noticed a lot of European men posting their hep c status too but for real : don’t put your trust in a drop down menu or dudes keying false info either thru intent or negligence.
Excellent post. Like Steven, I was taken aback with your “own pipe usage” statement, but once I thought about it, I fully understand your statement. Very similar to giving clean works to IV drug users-if they are not going to stop, at least try an approach that may keep them and others healthy.
AND I FORGOT TO ADD:THIS IS FOR DANIEL-HEPATITIS C IS NOT A PLAQUE OR LIKE YOU MENTIONED A NEW PLAQUE.HEPATITIS C IS A MANAGABLE DISEASE THAT CAN BE DEALT WITH.DONT GET ME WRONG IT IS THE DEADLIEST OUTTA ALL THE TYPES BUT IS MANAGABLE.YOU CAN STILL BE IN PERFECT HEALTH!AS FAR AS A CURE YOU CAN COMPLETLY ERADICATE THE VIRUS OUT OF YOUR BODY BUT THIS IS SOMETHING CALLED SVR…MORE LIKE A REMISSION PERIOD.BECAUSE HEPATITIS C IS NOT SEXUALLY TRANSMITTED IT IS NOT RECOGNIZED IN MANY CLINICS NOR HIV/STD CLINICS BUT I HONESTLY THINK IT SHOULD BE!ROUGH SEX CAN BE A FACTOR IN CONTRACTING HEPC.BOTTOM LINE HEPATITIS C IS MANAGABLE IF YOU ARE AWARE THAT YOU INFECTED
I can not believe the information here. Thank you so much for sharing it. I am actually going down to the health department tomorrow to be tested again for HIV as my last one was back in July and I would like to keep assurance that I am being carefully enough with my husband. Now that you shared this information, I will be SURE to be tested for everyone as well as others that people may not think they are passing along ..And I really don’t think you should have even put that drug comment in as that is condoning it and telling people it’s okay.. David, I have visited this blog many of times and never left one comment. So I guess this sums it up.
I guess someone didn’t like my previous post because it disappeared. I will say it again, good post but the article you cite is about 15 years out of date. There IS a cure for hepatitis C. It is called combination therapy, it consists of interferon and an oral anti-viral such as ribavirin. It isn’t pleasant, and many never complete treatment because of the side effects. I did complete therapy and am diagnosed as completely cured, thank god. The only thing I know is I caught it in the military, hepatitis C affects a lot of veterans for some reason, it’s important to get checked.
headline hyperbole
What a comfort to know that rimming only puts you at risk for Hepatitis A, not B and C. I wonder about that. Fecal matter can certainly contain blood cells. How about checking the accuracy of that before rimmers think they are okay. And how about an article on what constitutes a safe barrier for rimming?
If it is rimming, you can certainly correlate it, or anything else, to the frequency it is seen in porn. Over the years, I have seen a greater and greater emphasis on rimming and fucking, as if we are heterosexuals. Well, it’s all the Devil’s handiwork, anyway…
The flip side to the casual sex and drug lifestyle isn’t discussed enough. Thanks for this article. The liver is like a living miracle. No one in his right mind would want to do anything to harm it. These incurable viruses — HPV, herpes, HIV, hepatitis — are hellish.
Interesting reading! Specially the meth angle. Given the CDC’s penchant for sticking the heads in the sand (assuming they could get them out of their asses) it is no small wonder they have not come to terms with hep-c as an encroaching force. If they WERE to take it seriously, we’d have a whole hell of a lot more advertising about it, scads more education in schools etc… but, alas… we are still suffering Reagen mentality in this country when it comes to proactive protection and information dissemination!
I totally support your article but find the CDC findings extremely naive with what has been learned over the last 30+ years regarding
discoveries relating to HIV transmission. The comment regarding complete abstinence from Meth is equally naive where abstinence is unrealistic historically.
As i mentioned earlier and a few othewrs have backed me up like David. There is a cure for hep c. I have had a liver transplant at St louis University and their Drs are leaders in the world. They have many patients theyve treated who have been cured including Naomi Judd. People spreading incorrect information on the incredible advances in treatment are potentially doing great harm to people who read this blog. THERE IS A CURE FOR HEP C
I been HIV for 22 yrs….and so lucky that my colds, fevers are not HIV related. But I also have Hep C, and what read that the infer for the LIVER will not work? I ask you, cuz I’m going start it in March 2013..From what read, your FUCK with Hep C?
I know people who have been treated and cured of Hep C too. However, it’s not 100%. I know three people who have had the treatment. It was a lengthy , medicine intensive procedure which lasted a year and often made them sick and miserable. Before being accepted for treatment they had to meet specific criteria to even be certified that they might benefit from the treatment. Avoiding infection is easier than getting treated for it. One of those Hep varieties can be caused by alcohol abuse too, if one drinks enough to damage the liver. All STDs are a testament to why Same Gender Loving men need to settle down. We might protect ourselves from HIV but there are so many others, (i.e crabs, Herpes, Hep C), which we’re not even considering and condoms can’t do a thing against them. Men, quit hoeing! There ain’t an ass or a dick in this world worth dieing for!
i have had hepatitis c before and it is rather a difficult treatment to endure that was back in 2000 and a year of interferon injections and ribavirin is very nasty and expensive to treat….it is hard to pass to each other sexually if both are negative but is now considered a std if you are already poz and can be transmitted if you are poz and bb….also avoid those back alley tatoos the virus actually is able to live in the ink and is transmitted that way as well…there are better treatment options availabe today using pegulated interferon and the 2 new protease inhibitors for hep c and the sucess rate is much better than in 2000…as part of your bloodwork ask your medical provider to test you for hep c if you dont know your other status
I didn’t take issue with your meth statement the first time I read the blog. After reading the comments and the complaints about your statement I re-read it. You said, “if not by avoiding meth, but” which I understand to mean the best way to avoid a possible meth related transmission is to not smoke it at all, but if you can’t give it up then don’t share pipes. Your meth theory doesn’t sound like condoning it’s use at all to me. (And Brother Dave your comment about your previous comment about a cure having been deleted is incorrect. It’s still there 4th from the top.)
My doctor told me once, and i later confirmed it by reading some medical literature, that in around 25% of the HEP C cases the transmission source is unknown…and by unknown, scientists open the door for sexual transmission as one of the causes(yeah, rimming can be a risky pleasure!)
It use to be, “So many men, so little time”. It seems the more men you have, the more little time you have left on earth. Some of these men are sooooo hot, but I am getting on the verge of parnoid. A doctor once told me, ” Don’t let one mans pleasure, be your pain.” How true.
AAAAACK– OK, I love the article, I hate the chart. As one of the national Hepatitis Prevention experts there are some issues. Darmouth should be shot for that chart(it is wrong on my levels because of use of pure definition.) Sexually there are no black and whites only gray and variaants (think Clinton and the blow job) One mans sex is another non-sex–REMEMBER, There are no absolutes in the transmission of any viral disease. There are ways you are less able to transmit than others. The minute you say it wont, or cant you will find incidence where potentially did.(we don’t completely understand how Hep C actually transmits or infects the liver yet) Some one early on talked about CDC’s head being in the sand, it is true- I am one of the first to tell CDC that to their faces (and have many many times over the last 30 years), CDC is too slow to respond, has become too political and only base finding on 8 year old information(that is how long it takes to clean and process the data) and have very little real time feed back mechanisms. That said, when it comes to Hep C and the male and female Gay community and its allies, I prefer to make error on the side of caution. Hep C can be transmitted sexually, and has been happening more frequently. You just have to adjust your definition of sex to an inclusive model not exclusive. The inclusive model of sex means all activities, not just sliding “tab A” into “Slot B”… Sex is about a grouping of activities or behaviors, this includes the use of insertive toys, fingers, gadgets and gizmos…all of which can transfer/inoculate an individual with small amounts of viral infected blood –if toys/objects are shared with out PROPER sterilization, (or in the cases of three ways fingers go from hole to hole of various people) The chart was extreme misleading, and NOT accurate. When we look at Hepatitis Safety there are some core rules, most important get you Hep A/B vaccinations if you have not had them, If you don’t remember get them again it wont hurt you. Sex toys should not be shared with out real sterilization, that includes a pre-wash, a sterilization soak(as instructed on the bottle) and some heat(boiling for silicone toys) when ever possible. (Hep c will Encapsulate in some cases when exposed to incorrect Chlorine levels and will remain viable) Clean your slings people, with real approved agents, wipe down hard surfaces, portion out lubricants don’t dip out of the master jar, With play rooms and big toys like slings or crosses, wrap potential contamination areas with saran wrap, that can be easily disposed of. Keep Nitrile gloves on hand and use them(pun intended), On that note remember, HEP C does transmit on devices used for the inhalation of powdered drugs ie dollar bills, straws, spoons, is the mucus/snot of the person using the device prior has blood in it. Hep C in the gay community is already bigger than HIV in numbers. Take action to prevent it, if you engage in ANY potential risk activities, have you MD test you annually for Hep C with your HIV and STD tests. For more information on transmission got to CDC.gov/hepatitis
WOW THERE ARE REALLY ALOT OF THINGS THAT I DIDNT KNOW AND I AM A GRADUATE OF A MEDICAL SCHOOL AND WE NEVER EVEN MENTIONED ANYTHING ABOUT HEPATITIS C. BUT I AM AN EDUCATOR ON ALOT OF TOPICS THAT THE GAY COMMUNITY NEEDS TO KNOW THAT NEEDS TO BE SPOKEN ABOUT. AND THIS TOPIC RIGHT HERE I REALLY HAVE TO GO AND LET MY FELLOW GROUP ATTENDERS KNOW THAT IT IS OUT AND IT IS REAL.
I know the article was primarily about Hep-C, but I want to mention (because I didn’t see anyone else mention it, and I don’t know if it is commonly known): There is a vaccine for Hep-B. It is easy to get this vaccine and I highly recommend it. Hep-B can be fatal. I had Hep-B about 20 yrs ago and was very fortunate that my immune system fought it off. I’m antigen negative and antibody positive… which means there is zero virus in my body (I can never pass it on to anyone), and I have the antibodies to forever protect me from re-infection. I feel like I really dodged a bullet. It is so easy to protect yourself from this. If there was a vaccine for HIV, most everyone would get it. Well, there *IS* a vaccine for Hep-B…. what’s your excuse not to get it?
Was actually at a routine dr’s appointment today and was told they are recommending hep c screenings. Went and had a simple blood test. Now I see this blog. Glad I had it done, you never know!!
Can we get some more info here on Hep C and rimming?
Dumbass headline coupled with outdated info.
Wow David Beck I see you really pushed some peoples “buttons” with this topic lol..now I’ve always been std free and don’t take it for granted,but in just being online for many years,I’ve also noticed more guys posting “Hep-C neg”,or what’s even kind of odd is when a guy is Hiv Positive,then he’ll expect someone to be Hep-C Neg..weird!..also it seems like a lot of this stems from a lot of hard drug use,especially with guys who are Hiv Poz,I notice a lot of profiles that say they’re always lookin for a “party”,or “parTy”,or “bring your own supplies”,or even “I like smokin clouds”,its all code for “I’m a meth-head,coke head,crack head”,I honestly think its their way of dealing with having HIV..this is just what I’ve observed and I’M SURE there are plenty of nice non-drug using guys that have contracted STDS unknowingly,so this is strictly what I see..so not trying to offend..but yea..STDS are getting really bad now,especially when guys say they are “clean” or are “undetectable” but otherwise “STD FREE”..what?! Lol..crazy..anyway..good topic..
Interesting all of the emphasis seems to be on drug use. I think it gives the false sense of security that if you don’t PNP, you won’t get it. I have never used any drugs my entire life. In my regular blood tests, the doctors told me I was exposed to Hep C at some point and my body fought it off on its own. So they can determine you were exposed at one point but do not actually have it. Very lucky and my body is less susceptible to contracting it again as a result, although it does not make you immune, as once was thought.
While it is important to protect ourselves from virus’s such as Hepatitis C, it is all the more important to actually be factual. With a proper medication regiment, 80% of the people are cured. Keep in mind Meth users, etc that are not likely to follow thru on the medication drop that overall figure to as little as a 50% cure rate. A few people even thought they follow thru the regiment will not become Hep C clear though. Wikipedia actually has an excellent coverage that is currently completely up to date. Meth and Chemical drugs are a detriment to those who use them, and those who enable them, however, I do not believe in the theory that passing a pipe will spread Hep C any more then I think that kissing spreads HIV. Now the carelessness of a Meth life style in turn would likely cause the spread of Meth because they may easily forget to use UNIVERSAL PRECAUTIONS when it comes to their life and become infected thru other KNOWN forms of transmission totally unawares in the drugged our minds:( Tweakers as we call them around here are generally lucky to live past 40 and look like hell by age 25 if they continue on their chemical drugs… Sad Sad Sad waste of a life… But not much we can do about that…
OOPS I meant to say spread of HEP C and not Meth… LOL
There is no total cure…the treatment puts it in remission, but its not totally gone. Those who think they are cured? Give your liver a hard time with smoking, drugs, alchol, fatty fried foods…ect…and it will be back..worse than before. All the statements he made are true, wouldn’t you rather not have rough sex if you really liked the guy? Blood transfer is the only way you can get it, so wise up! Better to be safe..than sorry.
i will keep rimming clean butt holes. nothing wrong with it and bi men go crazy. its my choice and my life.
There are some forms of treatment out there that are showing promise, but currently the “cure” rate is statistically about 50%. The standard 50% rate treatments themselves are almost worse than the disease with the side effects from highly toxic interferon which must be included as a booster to the immune system. Nothing can keep someone from being reinfected either. The promise of new protease inhibitor drugs can increase the rate up to appoximately 80% but it is still in testing phases, plus it will be super expensive and likely to be denied by insurance if there is another “standard” option. (at least in the U.S. anyway). Help is on the way, but the time factor before we have a certain cure is still years off. The point is that it would be best to not get infected to begin with.
BOTTOM LINE PEOPLE HEPATITIS C ACTS DIFFERENTLY IN EACH ONES BODY…I TESTED POSITIVE FOR HEP C IN FEBRUARY OF THIS YEAR BECAUSE MY DUMBASS GOT A TATTOO FROM A DIRTY NEEDLE AT THE AGE OF 17…THERE IS A CURE BUT NOT A PROMISED CURE!LIKE I MENTIONED BEFORE HEPATITIS C DOES NOT AFFECT ME AT ALL..MY DOCTORS URGED ME NOT TO TREAT THE VIRUS BECAUSE MY VIRAL LOAD WAS SO SMALL AND THE VIRUS WASNT DOING ANY DAMAGE!AND AGAIN HEPATITIS C IS NOT A DAMN STD!!!!!!!!IT IS AN INFECTOUS DISEASE PASSED ON THROUGH BLOOD!!!!!I WOULD HAVE TO CUT MY ARM AND PINN YOU DOWN AND MAKE YOU DRINK MY BLOOD IN ORDER FOR YOU TO CONTRACT HEPC!AND MY HEALTH IS BEYOND GOOD!
I’m glad some knowledgable posters have also said there is a cure. I know people who have been cured. Not remission curede. Once again, I’m very fortunate to live in St louis with leading edge liver research being done. Anyone fortunate enough to live near a teaching and research hospital you would be well advised to see the top DRs at those facilities. I had a friend who died from hep c, when he might have been cured or the disease slowed down. He didnt want to change drs. Anyone who is able to get to the top dr in their area, and chooses not to, is putting their life at risk. Guys find the top Liver specialist that you can rerasonably travel to, it will be well worth it.
with all these damn diseases… why do any of us even have sex. fuck!!!
David – this is an important and needed post but it does contain outdated and incomplete information. It should be taken down and reworked.
Any person being treated for HIV is at much greater risk for Hep infection and is screened annually. Any sexually active gay man should have the Hep A/B vaccine.
Part of the reason you are seeing an increase in HEP C is that it wasn’t discovered and declared as HEP C, separate from A and B, until 1990.