Three scientists have won the Nobel Prize for medicine for discovering the liver-ravaging hepatitis C virus, a breakthrough that led to cures for the deadly disease and tests to keep it out of the blood supply.
Americans Harvey J Alter and Charles M Rice and British-born scientist Michael Houghton were honoured for their work over several decades on an illness that still plagues more than 70 million worldwide and kills over 400,000 each year.
The challenge now is to make these still-expensive drugs more widely available and to stem the spread of the disease among drug users, whose sharing of needles has led to spikes in cases.
“What we need is the political will to eradicate it” and to make the drugs affordable enough to do it, Mr Alter said.
Scientists had long known of the hepatitis A and B viruses, spread largely through contaminated food or water, and blood, respectively, but were “toiling in the wilderness” to try to explain many other cases of liver disease until the blood-borne hepatitis C virus was identified in 1989, said Raymond Chung, liver disease chief at Massachusetts General Hospital.
Now it is the only chronic viral infection that can be cured in almost all cases within a few months, using one of about half a dozen drugs, Dr Chung said. Without such treatment, the virus can lead to permanent scarring of the liver, cancer or the need for a transplant.
In an interview with the Associated Press, Mr Rice said he is most proud that the group’s work quickly led to a test to screen donors and make the blood supply safer.
“We take it for granted that if you get a transfusion, you’re not going to get sick from that transfusion. That was not the case before but is certainly the case now,” he said.
“Now it’s one in a million,” Dr Goodman said.
Mr Rice, 68, worked on hepatitis at Washington University in St Louis and now is at Rockefeller University in New York.
Mr Alter, 85, worked for decades at the US National Institutes of Health and remains active there.
Mr Houghton, 69, was born in Britain and worked on hepatitis at Chiron in California before moving to the University of Alberta in Canada.
Mr Alter first discovered that blood from patients who did not have hepatitis B could still cause liver inflammation and disease, but for years the cause was unknown.
A breakthrough came in 1989 when Mr Houghton and others at Chiron cloned the virus, making its genetic identity known and allowing further research on it, said Nobel Committee member Gunilla Karlsson-Hedestam.
“We have not seen any more cases since 1997” of hepatitis from a transfusion, Mr Alter said. “Currently we can cure virtually anybody who’s identified. With that, it’s possible to maybe even eradicate this disease over the next decade.”
Nobel Committee member Patrik Ernfors drew a parallel between this year’s prize and the rush by millions of scientists around the world to find a vaccine to combat the coronavirus pandemic.
“The first thing you need to do is to identify the causing virus,” he said. “And once that has been done, that is, in itself, the starting point for development of drugs to treat the disease and also to develop vaccines against the disorder.”
Mr Alter and Mr Rice are now working on coronavirus research, while Mr Houghton is trying to develop a hepatitis C vaccine. He said manufacturing delays have been a problem but he expects clinical trials to begin next year in many countries, including the US, Germany and Italy.
“To control an epidemic, you need to have a vaccine,” he said. For “diseases like gonorrhoea, syphilis, chlamydia, we’ve had cheap drugs available for decades, and yet we still have big epidemics of those diseases”.
Hepatitis C drugs were around 40,000 dollars when they first came out less than a decade ago. They have come down to roughly a quarter of that but are still out of reach for much of the world.
India, eastern Europe, Egypt and parts of Asia, including Mongolia, remain the areas hardest hit.