Illustration of Harvey J. Alter, Michael Houghton and and Charles M. Rice
Illustrations of Harvey J. Alter, Michael Houghton and and Charles M. Rice | Twitter: @NobelPrize
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Bengaluru: The Alfred Nobel Prize committee awarded the Nobel Prize in Physiology or Medicine this year jointly to UK and US scientists Harvey J. Alter, Michael Houghton and Charles M. Rice for their role in the discovery of the hepatitis C virus.

The hepatitis C virus (HCV) causes inflammation of the liver and can spread through blood transfusions. Blood-borne hepatitis C is a major contributor to morbidity and mortality, causing over a million deaths a year globally.

The disease is considered a global public health problem at a scale comparable to HIV and tuberculosis.

ThePrint looks at the discovery of the hepatitis C virus and the contribution of the laureates.

Also read: This is how remdesivir, developed for Hepatitis C and Ebola, fights Covid-19

Hepatitis C causes liver inflammation

Hepatitis is a form of liver inflammation primarily caused by viral infections, and also by toxic environmental effects, alcohol abuse or autoimmune disorders.

Hepatitis C is an infectious disease caused by the hepatitis C virus (HCV) that affects the liver and causes inflammation. It is a single-stranded RNA virus and can be transmitted through blood and injections with injected drug use being the biggest cause in high-income nations.

Unsafe medical procedures and unsafe body modifications (underground tattoos and piercings) also contribute to its transmission. It can occur after blood transfusions as well.

Nearly 80 per cent of people exposed to the virus get the disease but nearly half the people infected with the virus recover on their own.

In the early stages of infection, there are mild symptoms such as fever, abdominal pain, weight loss, fatigue, and jaundice. However, liver inflammation can persist in the body for several years, leading to liver disease and cirrhosis (long-term liver damage preventing liver functioning). This can lead to liver failure or even liver cancer.

No approved vaccines exist for HCV even though there are vaccines for hepatitis A and B. However, the disease can be treated successfully. Preventive measures include using sterile injections where needed and rigorous screening of blood donors.

Virus discovery and contribution of laureates

The discovery of hepatitis C virus can be traced back to the mid-1970s, when laureate Harvey J. Alter was the Chief of the Infectious Disease Section in the Department of Transfusion Medicine at the National Institutes of Health, which is the apex US agency for public health research.

Alter’s team demonstrated that the hepatitis that occurs after blood transfusion is not caused by hepatitis A or B virus.

Research on identifying the cause was stalled for a decade, but in 1987, laureate Michael Houghton, along with virologists Qui-Lim Choo and George Kuo made a landmark discovery. In collaboration with virologist Daniel W. Bradley of the Centers for Disease Control and Prevention (CDC) in the US, the team managed to identify the hepatitis C virus and develop a diagnostic test.

Alter then confirmed the presence of viruses in other specimens in 1988.

Houghton, Choo and Kuo then worked for Chiron Corporation, a US biotechnology company. A patent battle ensued with CDC, which was subsequently dropped after Chiron paid $1.9 million to CDC and over $300,000 to Bradley.

The same year, Charles M. Rice, then a researcher at Washington University, identified a part of the HCV genome that was responsible for viral replication. He genetically engineered a modified HCV and by testing on chimpanzees, was able to prove that HCV solely causes hepatitis through transfusion.

Selection controversy

Despite working with both Choo and Kuo at Chiron, science and research awards have been presented to Houghton and Bradley alone.

Houghton was awarded the prestigious Canada Gairdner International Award in 2013, which he declined to accept stating that it was unfair of the award to leave out seven years of close collaboration with Choo and Kuo. Alter and Bradley were awarded the Gairdner Prize as well.

Houghton and Alter were also awarded the Albert Lasker Award for Clinical Medical Research, which they both accepted. Houghton has also accepted the Nobel saying that it would be too presumptuous of him to turn down a Nobel.

None of the awards recognised Choo or Kuo.

Also read: Cheers to health! This was a decade of drug breakthroughs – from Cancer to Hepatitis C

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