Discovery of the Hepatitis C virus wins 2020 Nobel Prize for Physiology or Medicine © Ill. Niklas Elmehed. © Nobel Media.

Discovery of the Hepatitis C virus wins 2020 Nobel Prize for Physiology or Medicine

The prize was jointly awarded to three scientists whose work led to the development of medicines that saved millions of lives.

The 2020 Nobel Prize for Physiology or Medicine has been jointly awarded to three scientists, including a British professor.

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Britain’s Michael Houghton, along with Americans Harvey J Alter and Charles M Rice were awarded the prize for the discovery of the Hepatitis C virus.

Prior to their work, while the discoveries of the Hepatitis A and B viruses were vital, the majority of blood-borne hepatitis cases remained unexplained. The identification 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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According to the World Health Organisation, there are more than 70 million cases of hepatitis worldwide and 400,000 deaths each year.

The award comes with a gold medal and prize money of 10 million Swedish kronor (£867,000), courtesy of a bequest left 124 years ago by the prize’s creator, Swedish inventor Alfred Nobel.

Prof Harvey J Alter studied the occurrence of hepatitis in patients who had received blood transfusions at the US National Institutes of Health. His investigations defined a new, distinct form of chronic viral hepatitis, which became known as non-A, non-B hepatitis.

British-born scientist Prof Michael Houghton then undertook work to isolate the genetic sequence of the virus. His work identified the Hepatitis C virus, developed blood tests and identified new drug targets for this virus as well as developing a vaccine for clinical development.

Prof Charles M Rice, a researcher at Washington University in St Louis, found that Hepatitis C virus alone could cause the unexplained cases of hepatitis.

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Announcing the prize in Stockholm on Monday, the Nobel Committee noted that the trio’s work helped explain a major source of blood-borne hepatitis that could not be explained by the Hepatitis A and B viruses.

“Thanks to their discovery, highly sensitive blood tests for the virus are now available and these have essentially eliminated post-transfusion hepatitis in many parts of the world, greatly improving global health,” said the Nobel Committee.

“Their discovery also allowed the rapid development of antiviral drugs directed at Hepatitis C. For the first time in history, the disease can now be cured, raising hopes of eradicating Hepatitis C virus from the world population.”

In the 1960s, Baruch Blumberg determined that one form of blood-borne hepatitis was caused by a virus that became known as Hepatitis B virus, and the discovery led to the development of diagnostic tests and an effective vaccine.

He was awarded the Nobel Prize in Physiology or Medicine in 1976 for this discovery. Researchers then began the work of identifying the novel virus, including Alter, Houghton and Rice.

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All three scientists will receive one third of the prize each.

How do scientists develop vaccines for new viruses?

Vaccines work by fooling our bodies into thinking that we’ve been infected by a virus. Our body mounts an immune response, and builds a memory of that virus which will enable us to fight it in the future.

Viruses and the immune system interact in complex ways, so there are many different approaches to developing an effective vaccine. The two most common types are inactivated vaccines (which use harmless viruses that have been ‘killed’, but which still activate the immune system), and attenuated vaccines (which use live viruses that have been modified so that they trigger an immune response without causing us harm).

A more recent development is recombinant vaccines, which involve genetically engineering a less harmful virus so that it includes a small part of the target virus. Our body launches an immune response to the carrier virus, but also to the target virus.

Over the past few years, this approach has been used to develop a vaccine (called rVSV-ZEBOV) against the Ebola virus. It consists of a vesicular stomatitis animal virus (which causes flu-like symptoms in humans), engineered to have an outer protein of the Zaire strain of Ebola.

Vaccines go through a huge amount of testing to check that they are safe and effective, whether there are any side effects, and what dosage levels are suitable. It usually takes years before a vaccine is commercially available.

Sometimes this is too long, and the new Ebola vaccine is being administered under ‘compassionate use’ terms: it has yet to complete all its formal testing and paperwork, but has been shown to be safe and effective. Something similar may be possible if one of the many groups around the world working on a vaccine for the new strain of coronavirus (SARS-CoV-2) is successful.

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