A trio of scientists from the U.S. and the U.K. won this year’s Nobel Prize in Physiology or Medicine for the discovery of the hepatitis C virus, a major cause of liver cancer.
Americans Harvey J. Alter and Charles M. Rice, and Briton Michael Houghton were awarded the prize for “a landmark achievement in our ongoing battle against viral infections,” the Nobel Assembly said.
The scientists have “made a decisive contribution to the fight against blood-borne hepatitis, a major global health problem that causes cirrhosis and liver cancer in people around the world,” the Assembly said.
Hepatitis is a disease marked by inflammation of the liver. Before the prizewinning research in the 1970s, researchers had discovered two forms of the disease. Hepatitis A was transmitted via polluted water or food, while hepatitis B spread through the blood.
But doctors and researchers couldn’t explain most bloodborne hepatitis cases. These mysterious cases were especially insidious, because infections often became chronic, which can lead to liver failure and cancer.
Discovery of a third kind of hepatitis virus suddenly explained the source of these infections that were surfacing in baby boomers, many of whom had received blood transfusions, shared needles or were infected through sexual intercourse with someone who was infected.
Tens of thousands of people, including thousands of Americans, were dying each year due to the hepatitis C virus. It was also a leading reason for liver transplants.
After the findings, scientists developed a blood test that could detect hepatitis C. Blood banks used the test to make sure donors didn’t carry the virus and donations wouldn’t transmit it to people getting transfusions.
“Before the discovery of the hepatitis C virus it was a bit like Russian roulette to get the blood transfusion,” said Nils-Göran Larsson, a member of the Nobel Committee for Physiology or Medicine 2020. “So I think it has benefited millions of people that we now can have safe blood transfusions and safe blood products.”
Drugmakers, meantime, began developing hepatitis C treatments. The latest drugs, which have rung up billions of dollars in sales, can now cure most patients.
The discovery of the hepatitis C virus “is a remarkable story of public health and medicine and what we’re able to do,” said Elizabeth Verna, a transplant hepatologist and associate professor of medicine at Columbia University Vagelos College of Physicians and Surgeons. “We’re now able to cure patients with hepatitis C more than 95% of the time with the first treatment.”
Dr. Alter’s work at the U.S. National Institutes of Health in the 1970s showed that blood from transfusion patients could transfer the disease to chimpanzees and demonstrated that the unknown infectious agent had the characteristics of a virus. It became known as “non-A, non-B” virus.
“One of the greatest thrills for me was having identified the first patient with non-A and non-B, and see that not only that he was cured, but everyone else that’s been followed over the years being cured,” Dr. Alter said in a conference call with reporters. “I could never have imagined this really, not in my lifetime.”
Dr. Houghton, working for the pharmaceutical firm Chiron, was able to isolate the genetic sequence of the then-unknown virus in the late 1980s.
He and fellow researchers named the virus hepatitis C. Their work eventually led to a blood test that could screen for the virus.
“We thought it would be solved quickly, but it actually took seven years to find” and an additional two or three years to develop blood tests to screen for the virus, said Dr. Houghton, who is now the Canada Excellence Research Chair in Virology at the Li Ka Shing Institute of Virology at the University of Alberta.
In the 1980s and 1990s, Dr. Rice, then a researcher at Washington University in St. Louis, helped do work that demonstrated the newly discovered virus alone caused hepatitis C.
Dr. Rice and other researchers found a component at the end of the hepatitis C virus genome that appeared to play an important role in the virus’s ability to replicate. Dr. Rice also found some genetic variations in hepatitis C virus samples that he thought would hinder replication of the virus.
Based on the findings, he engineered in the lab a variant of the hepatitis C virus, the first that could be cultured and studied in the laboratory, and injected this variant into chimpanzees. He and his colleagues were able to detect the virus in the animals’ blood and saw the kinds of liver changes seen in humans with the disease.
The findings showed that the hepatitis C virus alone caused the unexplained cases of hepatitis in blood-transfusion patients.
The Nobel Prize committee wasn’t able to reach Dr. Houghton and notify him of the prize. Lorne Tyrrell, the Li Ka Shing Institute’s director, said he saw the announcement in Alberta and called Dr. Houghton, who was in San Francisco at the time.
Dr. Rice said he initially ignored his ringing phone at 4:30 this morning. When it rang some more, however, Dr. Rice said he grew worried someone from his laboratory was calling to warn of a problem with a freezer and valuable samples were in peril.
Once he heard the Swedish-accented voice on the line mention the other two Nobel Prize winners—Drs. Alter and Houghton—Dr. Rice said it began to dawn on him: He was receiving the prize.
Likewise, Dr. Alter said he was in a deep sleep when he heard the phone ring at 4:15 a.m., and ignored not only the initial call but a second one. By the third call, he said, he “got out of bed rather angrily, figuring this was another political solicitation or someone wanting to extend the warranty on my car.”
It turned out to be from Stockholm, telling him he had won a Nobel Prize. “It’s been quite a morning since that time.”
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