The first of the six Nobel Prizes set to be awarded throughout the week was announced by the Nobel Committee during a press conference at the Karolinska Institute in Stockholm, Sweden on Monday, Oct. 5. The prize for medicine was awarded to a trio of scientists and researchers: Harvey J. Alter, Michael Houghton, and Charles M. Rice, jointly responsible for first discovering, identifying and testing the Hepatitis C virus.
Various factors ranging from alcohol abuse to certain medications can cause hepatitis, a condition defined as the inflammation of the liver. Among these, the Hepatitis A virus and Hepatitis B virus were known common causes of the condition by the 1960s. For most individuals infected by either virus, the disease lasts only short-term, and both are preventable by vaccination. In some cases of Hepatitis B, however, the patient’s condition might degenerate to that of a chronic liver infection. In these cases, cirrhosis and liver cancer may result.
Throughout the 1960s, as awareness of both Hepatitis A and Hepatitis B grew within the medical community, a similar condition evaded identification. A portion of patients who underwent blood transfusions began to develop chronic hepatitis, though neither the Hepatitis A virus nor the Hepatitis B virus were the cause. Scientists struggled to identify this unknown disease.
In 1972, Professor Harvey J. Alter first determined that the mysterious symptoms present in transfusion patients came as a result of a disease entirely separate from the known Hepatitis A and B viruses. Blood taken from patients who tested negative for Hepatitis B could still cause chronic hepatitis in transfusion patients.
This new disease evaded proper identification until nearly three decades later. In 1989, Professor Michael Houghton successfully cloned and identified the genetic sequence of the virus. From here, it took the name “Hepatitis C”, and further research swiftly came underway.
Professor Charles M. Rice, in 1997, proved indisputably that the Hepatitis C virus caused the symptoms seen in infected blood transfusion patients by testing a genetically engineered duplicate of the virus into the livers of chimpanzees. The tools and research developed by Rice opened the door for further testing and the development of potential treatments. As stated in the Nobel Assembly’s official press release on the matter, the contributions of Alter, Harvey, and Houghton to the study of Hepatitis C “made possible blood tests and new medicines that have saved millions of lives.”
When doctors first began documenting cases of Hepatitis C, the virus itself did not even have a name, and researchers had little evidence to guide their search. As Houghton himself explains, “We had limited tools available to us then, so it was rather like searching for a needle in a haystack.” The symptoms of chronic hepatitis observed in blood transfusion patients in the 1960s had no existing explanation nor an effective treatment. Today, modern treatments eliminate the virus in most patients within 8-12 weeks.
Due to advancements in testing, doctors can now identify the virus in blood samples to avoid using those samples in blood transfusions. Before modern screening procedures, blood transfusions resulted in the transmission of Hepatitis C in as many as 1 in 10 cases. Today, not a single instance of the disease spreading via blood transfusion has occurred since 1997.
Hepatitis C persists as a global health issue. More than 70 million cases exist across the world, with transmission commonly occurring as a result of the unclean and unsafe sharing of needles during drug use.
Treatment also remains expensive, with some sufferers of Hepatitis C unable to afford the appropriate medicine. However, given the rate at which modern medicines can cure the disease, both the World Health Organization and Alter himself hope to rid the world of Hepatitis C in the near future. “Currently we can cure virtually anybody who’s identified. With that, it’s possible to maybe even eradicate this disease over the next decade,” says Alter.
Both Alter and Rice now contribute to the ongoing research into the novel coronavirus dominating the medical sphere today. Houghton continues working toward a potential vaccine against Hepatitis C. Together, these three researchers and the decision by the Nobel Committee to award their work represent the ongoing challenge that medical researchers face against viral infections.