Scientists Who Discovered Hep C Virus Awarded Nobel Prize For Medicine
Harvey J. Alter, Michael Houghton and Charles Rice will share the honor for their “seminal discoveries that led to the identification of a novel virus.” Other global pandemic developments are also in the news.
AP:3 Win Nobel Medicine Prize For Discovering Hepatitis C VirusAmericans Harvey J. Alter and Charles M. Rice and British-born scientist Michael Houghton won the Nobel Prize for medicine on Monday for their discovery of the hepatitis C virus, a major source of liver disease that affects millions worldwide. Announcing the prize in Stockholm, the Nobel Committee noted that the trios work identified a major source of blood-borne hepatitis that couldnt be explained by the previously discovered hepatitis A and B viruses. Their work, dating back to the 1970s and 1980s, has helped saved millions of lives, the committee said.
CNN:Nobel Prize In Medicine Awarded For Discovery Of Hepatitis C To Harvey J. Alter, Michael Houghton And Charles M. RiceGlobally, an estimated 71 million people have chronic hepatitis C virus infection, according to the World Health Organization. A significant number of those who are chronically infected will develop cirrhosis or liver cancer.Gilbert Thompson, professor emeritus of clinical lipidology at Imperial College London, told CNN: “It’s long overdue. Hep C arguably has caused just as much, if not more deaths, than the current coronavirus pandemic. It was a major problem and this was an enormous step forward.”
In other global news
E1 And E2 Glycoproteins
E1 and E2 are covalently bonded when embedded in the envelope of HCV and are stabilized by disulfide bonds. E2 is globular and seems to protrude 6 nm out from the envelope membrane according to electron microscope images.
These glycoproteins play an important role in the interactions hepatitis C has with the immune system. A hypervariable region, the hypervariable region 1 can be found on the E2 glycoprotein. HVR1 is flexible and quite accessible to surrounding molecules. HVR1 helps E2 shield the virus from the immune system. It prevents CD81 from latching onto its respective receptor on the virus. In addition, E2 can shield E1 from the immune system. Although HVR1 is quite variable in amino acid sequence, this region has similar chemical, physical, and conformational characteristics across many E2 glycoproteins.
Discovery Of Hepatitis A And B
In 400 B.C., Hippocrates called hepatitis infection as Epidemic Jaundice and told that The bile contained in the liver is full of phlegm and blood, and erupts..Such an eruption, the patient soon raves, becomes angry, talks nonsense and barks like a dog . During the second world war, the infection to the liver was thought of infection by several viruses and called it Viral Hepatitis. After that, in 1947, British hepatologist F.O. MacCallum has classified viral hepatitis into Hepatitis A which is Epidemic hepatitis and Hepatitis B which is serum hepatitis .
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The Nobel Prize In Physiology Or Medicine 2020 Was Awarded To Three Us And Uk Virologists For Contributing To The Discovery Of The Hepatitis C Virus
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 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 Antibody Test
Certain foreign substances that enter your body trigger your immune system to make antibodies. Antibodies are specifically programmed to only target the foreign substance they were made to fight.
If youve ever had a hepatitis C infection, your body will make hepatitis C antibodies as part of its immune response.
Your body only makes these antibodies if you have hepatitis C or had it in the past. So the hepatitis C antibody test can confirm whether you have the virus by testing for these specific antibodies.
It may take 2 to 3 months after exposure for the test to detect antibodies. If needed, your healthcare professional may order an HCV RNA test, which can detect the virus after just 1 or 2 weeks.
If the antibody test is positive, an HCV RNA test can show whether the infection is current.
While people of any gender experience the same hepatitis C symptoms, 2014 research suggested some effects of the virus may differ, depending on the sex you were assigned at birth.
Researchers noted that:
- women have a higher chance of clearing the virus without treatment
- liver disease may progress more rapidly in men
- men have a higher chance of developing cirrhosis
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A Pricey Drug And New Generics
The first combo pill with two drugs that inhibits different steps in hepatitis C replication was approved by the FDA in 2014. This pill is taken once a day for 8-12 weeks, has little to no side effects and improved the cure rate to 90-95%. It was hailed as a magical cure, but it came with a price tag of US$94,500 for a 12-week course of treatment. That led many insurers in the United States and national health departments in other countries to limit access to treatment.
Since then, several othercombo pills withsimilar cure rates that are equally well-tolerated have become available, and the cost has markedly decreased. In addition, low-cost generics and special pricing arrangements are available in many resource-limited countries.
While the current price of hepatitis C virus drugs is still very high, one needs to remember that for 95 percent of patients, this is a cure. It is unlike medicines for many illnesses that need to be taken for a long time, sometimes for the rest of the patients lives. Indeed, a cure for hepatitis C virus has allowed some patients who were on the liver transplant waiting list to reverse their liver failure, making transplantation unnecessary. This is good news not only for these patients but also for others on the waiting list.
Contributions Of The Nobel Prize Winners
As a researcher at the U.S. National Institutes of Health , Dr. Alter focused on identifying the cause of common, unexplained hepatitis infections in blood transfusion recipients who didnt have hepatitis A or B, two previously identified forms of the virus. Along with colleagues at the NIH, Alter found that there was a new, distinct form of the disease, which at that point they called non-A, non-B hepatitis.
More than a decade later, Dr. Michael Houghton, who at the time worked at the drug company Chiron, deployed novel research methods to identify the genome of the virus, which was named hepatitis C. Following this breakthrough, Dr. Charles Rice, then a researcher at Washington University in St. Louis, did experiments in chimpanzees to prove that the hepatitis C virus on its own could cause hepatitis in blood transfusion recipients.
Prior to their work, the discovery of the hepatitis A and B viruses had been critical steps forward, but the majority of bloodborne hepatitis cases remained unexplained, the Nobel committee said. The discovery of hepatitis C virus revealed the cause of the remaining cases of chronic hepatitis and made possible blood tests and new medicines that have saved millions of lives.
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The Future Of Hepatitis C Therapy
With such high rates of success with current treatments, it may seem like the hepatitis C story is in its final chapters, but it is not over yet. A vaccine against hepatitis C would cause the prevalence of the disease to plummet, but efforts to produce a vaccine, while still under way, have not yet been successful. While hepatitis A and B have vaccines, the hepatitis C virus is more variable than either of these viruses, which, along with other factors, complicates vaccine development efforts. Additionally, the current drugs show great promise, but the costs of the more successful FDA-approved DAA treatments are extremely high, which present a significant obstacle to many with the disease. But the research has come a long way. From the early investigations into a mysterious new virus, to the identification of the culprit, and the rigorous work to develop an effective treatmentthe story of hepatitis C is definitely a thriller.
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.
Alterâs 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 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.
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Zeroing In On The Hepatitis C Virus
The era of direct-acting antivirals that specifically target HCV began in 2011 with the U.S. Food and Drug Administration approval of the first protease inhibitors. These drugstelaprevir and boceprevir, along with several similar drugs approved latertargeted the HCV protease that is critical for viral replication. When used in conjunction with peginterferon and ribavirin, protease inhibitors yielded SVR rates of up to 75 percent. However, this triple therapy was accompanied by additional side effects to those already present with peginterferon and ribavirin. Nevertheless, the success of HCV-specific protease inhibitors showed that the virus had vulnerabilities that could be exploited by a well-designed and properly administered drug.
More new anti-HCV drugs were developed and tested over the next several years. These new drugs included sofosbuvir and dasabuvir, which interfered with the activity of the HCV polymerase, an enzyme that is responsible for the viral replication. Members of a second class of drugs, ledipasvir and daclatasvir, targeted the NS5A region of the virus, which makes a structural protein critical for viral replication. Many of these drugs were initially tested in conjunction with peginterferon and ribavirin, or in combination with a protease inhibitor. Generally, the results were SVR rates of at least 80 percent.
How Do People Get Hepatitis C
Hepatitis C virus is found in the blood of people with HCV infection. It enters the body through blood-to-blood contact.
Until reliable blood tests for HCV were developed , people usually got hepatitis C from blood products and blood transfusions. Now that blood and blood products are tested for HCV, this is no longer the typical means of infection.
Currently, people usually get hepatitis C by sharing needles for injection drug use. An HCV-infected woman can pass the infection to her baby during birth. It is also possible to get hepatitis C from an infected person through sexual contact, an accidental needlestick with a contaminated needle, or improperly sterilized medical, acupuncture, piercing, or tattooing equipment.
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Hepatitis C Virus Treatable Thanks To Discovery Of Nobel Winners
The 2020 Nobel Prize in Physiology or Medicine was jointly awarded to three scientists who discovered the hepatitis C virus, a feat that paved the way for new medicines and blood tests to detect the virus earlier, when its easier to treat.
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Before the discovery of the hepatitis C virus, perfectly healthy people often died as a result of blood transfusions that transmitted the virus. Today, thanks to this discovery, blood tests have largely eliminated hepatitis C cases caused by transfusions in much of the world, and more recently, antiviral drugs have been developed that can cure the disease.
This fall, Harvey J. Alter, MD Michael Houghton, PhD and Charles M. Rice, PhD, were jointly awarded the 2020 Nobel Prize in Physiology or Medicine for their contributions to the discovery of the hepatitis C virus.
For the first time in history, the disease can now be cured, raising hopes of eradicating hepatitis C virus from the world population, the Nobel committee said in a statement announcing the award.
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Discovery And Basic Characterization Of An Important Human Pathogen
et al.N Engl J Med.J Hepatol.Science.Liver Int.
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Liver Int.Intervirology.J Hepatol.Nature.Immunol Rev.Curr Infect Dis Rep.Nat Med.Clin Infect Dis.J Hepatol.Hepatology.
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History Of Discovery Of Hcv
The discovery of HCV has led to a major breakthrough in the treatment of liver cancer. The contribution of Michael Houghton, Harvey Alter, and Charles Rice was remarkable in the discovery of HCV. Hence, they are awarded 2020 Nobel Prize in Medicine. The disease can be cured for the first time in history, raising hope to save millions of people with acute HCV.
In 1989, a team of scientists at Chiron Laboratories led by Michael Houghton collected blood samples from infected chimpanzee and successfully cloned a small fragment of the genome of HCV in order to develop diagnostic tests.,, After this successful experiment, they tried to produce antibodies to HCV in human blood. Although infectious clones were successfully developed, tissue culture system for viral multiplication was not found.
A Researcher Reflects On Progress Fighting Hepatitis C And A Path Forward
The hepatitis C virus was discovered in 1989 research thats now earned a Nobel Prize.
When I began my medical career in Hong Kong in the early 1980s, I chose to focus on hepatitis B, in part because it was very common and because the hepatitis C virus had not yet been discovered. I witnessed the devastation that this virus caused cirrhosis, liver failure and liver cancer and the lack of treatments we could offer to patients.
Back then, scientists knew there was another type of hepatitis, but no one could identify it, so we called it non-A, non-B hepatitis. I would never have imagined that during the course of my career I would witness the discovery of what came to be known as hep C and the development of a cure for nearly all patients with chronic hepatitis C in 2014.
Underscoring the importance of these discoveries for global human health, this years Nobel Prize in Physiology or Medicine was awarded jointly to Harvey J. Alter, Michael Houghton and Charles M. Rice for the discovery of the hepatitis C virus.
Effective treatment for hepatitis C has become even more relevant today in light of the recent surge in new cases of hepatitis C due to rising opioid use.
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How Can I Prevent Passing On The Virus To Others
If you have a current hepatitis C infection you should:
- Not share any injecting equipment such as needles, syringes, etc.
- Not donate blood or carry a donor card.
- Not share razors, toothbrushes or anything else that may possibly be contaminated with blood.
- Use condoms when having sex. The risk of passing on HCV during sex is small but risk is reduced even further by using condoms.
- Advise anybody with whom you have had sex or shared needles to have tests as well, to check they do not have HCV.
There is currently no vaccine available to protect against hepatitis C.
Story Of Discovery: Hepatitis C: From Non
The story of hepatitis C from discovery to cure is very much like the plot of a good mystery novel. It begins with a puzzling who-done-it, followed by a lengthy hunt for the suspect, and, finally, rigorous efforts to subdue the perpetrator. Many of these efforts were spearheaded by the NIDDK, and, although the narrative is not quite finished, the battle against hepatitis C is evolving into one of the biggest modern success stories in scientific research.
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Identification Of Hepatitis C Virus
Identification of the novel virus was now a high priority. All the traditional techniques for virus hunting were put to use but, in spite of this, the virus eluded isolation for over a decade. Michael Houghton, working for the pharmaceutical firm Chiron, undertook the arduous work needed to isolate the genetic sequence of the virus. Houghton and his co-workers created a collection of DNA fragments from nucleic acids found in the blood of an infected chimpanzee. The majority of these fragments came from the genome of the chimpanzee itself, but the researchers predicted that some would be derived from the unknown virus. On the assumption that antibodies against the virus would be present in blood taken from hepatitis patients, the investigators used patient sera to identify cloned viral DNA fragments encoding viral proteins. Following a comprehensive search, one positive clone was found. Further work showed that this clone was derived from a novel RNA virus belonging to the Flavivirus family and it was named Hepatitis C virus. The presence of antibodies in chronic hepatitis patients strongly implicated this virus as the missing agent.
George Emil Paladewas the first Romanian to receive the Nobel Prize for Medicine in 1974 for his discoveries concerning the structural and functional organization of the cell. When Palade got the award, he was working at the School of Medicine of the Yale University. He got the award together with Albert Claude and Christian de Duve.