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started sweeping across the world, another, more
stealthy virus had been taking thousands of lives and evading treatment for years. Called the hepatitis C virus, it affects about 71 million people globally and was the last of the hepatitis strains to be identified. People who are infected may exhibit no symptoms for months or years, until they discover they have severe liver damage or liver cancer. Identifying hepatitis C led to new treatments and ways of identifying the virus in blood samples. Those breakthroughs came from work done by three scientists, including Dr. Harvey J. Alter, M.D, U.S. National Institutes of Health (NIH), who shared the 2020 Nobel Prize in Physiology or Medicine with Dr. Michael Houghton, Ph.D., University of Alberta, Canada; and Dr. Charles M. Rice, Ph.D., Rockefeller University in New York City. In announcing the award, the Royal Swedish Academy of Sciences noted, “Prior to their work, the discovery of the hepatitis A and B viruses had been critical steps forward, but the majority of blood-borne hepatitis cases remained unexplained. 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.” Unfortunately, due to the coronavirus pandemic, the usual Nobel Prize festivities in Stockholm had to be cancelled, and recipients took part in a remote awards ceremony. Harvey Alter jokes that he ignored two calls notifying him of the award, because the phone rang at about 4:15 a.m. EST. The third time the phone rang, he answered and was about to scold the caller, only to find out the call was from Stockholm. “It stopped me in tracks; I was stunned,” Alter says. “Often ballplayers say right after a good game that they don’t know what they feel yet, and that’s true. I didn’t know, but now my whole life has turned upside down.” Alter’s Nobel Prize comes after a half-century of research dedicated to the hepatitis virus. An intramural researcher at the NIH and a Senior Scholar at the NIH Clinical Center’s Department of Transfusion Medicine, Alter has been hard at work since the 1960s. “It’s been a very long process that has expanded incrementally,” he says. “We realized there was a new agent of hepatitis out there. We were able to define some physical characteristics of the virus and clinically found that about 20 percent of infected people went on to develop cirrhosis, which led to death, which made it an important disease.” In the past, hepatitis C was mostly transmitted by blood transfusions and unsterilized medical practices. Now it is almost exclusively contracted from needles shared during illicit drug use, according to Alter. “We can cure almost 100 percent of cases with few side effects with new and remarkable oral drugs. The impediment has been the cost of the drugs (in the United States). Now more insurance plans are covering it; initially many were denied treatment. We need massive screening programs to detect silent carriers and make treatment affordable once carriers are identified.” NORDICLIFESCIENCE.ORG 71