Two Americans and a British scientist have been awarded the Nobel prize in medicine for their groundbreaking work on blood-borne hepatitis, a health problem that causes cirrhosis and liver cancer around the world.
Harvey J Alter at the US National Institutes of Health in Maryland, Charles M Rice from Rockefeller University in New York, and Michael Houghton, a British virologist at the University of Alberta in Canada, were honoured for their joint discovery of the hepatitis C virus, a major cause of liver disease.
The award may prove controversial as Houghton recently turned down a major prize because it excluded two co-workers at the pharmaceutical firm Chiron who helped him identify the virus. In 2013, he refused the Canada Gairdner international award sometimes known as the “baby Nobel” because it did not recognise the work of his former colleagues George Quo and Qui-Lim Choo.
After reluctantly accepting the prestigious Lasker award in 2000, Houghton, who received his PhD from King’s College London in 1977, said his co-workers did not get the recognition they deserved and decided “I really shouldn’t do this any more.”
David Pendlebury, a citation analyst at Clarivate, a scientific data firm, said he was surprised the Nobel committee made the award knowing it would be problematic. “There’s no question about the importance of this work and the worthiness of this prize, but one assumes the Nobel committee tries to avoid controversy where possible,” he said.
The difficulty, he said, threw into high relief the perennial issue of the Nobel’s rule of three, where no more than three researchers can be named for discoveries that have often been team efforts.
The award, announced on Monday by the Nobel assembly from the Karolinska Institute in Stockholm, is worth 10m Swedish kronor (£870,000), to be shared among the winners.
At a press briefing after the announcement, Thomas Perlmann, the secretary of the Nobel committee, told reporters he had told Alter and Rice the news by telephone but had not reached Houghton. Alter said he ignored the phone twice when it rang before 5am local time. “The third time I got up angrily to answer it and it was Stockholm. It’s a weird experience,” he said. “It’s the best alarm clock I’ve ever had.”
The scientists’ work transformed the understanding and treatment of hepatitis C. The virus infects more than 70 million people, with 400,000 dying each year from related conditions such as cirrhosis and liver cancer, according to the World Health Organization.
In the 1940s, doctors knew there were two main types of infectious hepatitis. The first, transmitted by the hepatitis A virus, spread via contaminated food and water and tended to have little long-term impact on people. The second, spread by blood and body fluids, was more insidious. Patients could be silently infected for years before serious complications emerged – liver cancer and liver scarring known as cirrhosis.
Researchers discovered hepatitis B in the 1960s, but it quickly became clear that it was not the only cause of the blood-borne infections. While studying hepatitis spread by blood transfusions, Alter found that some patients were being infected by an unknown agent. Having a transfusion at the time was like “Russian roulette”, the Nobel committee said. Alter later showed that blood from the patients could transmit the disease to chimpanzees.
The next breakthrough came from Houghton and his colleagues at Chiron. Through a new and untested strategy, they used human antibodies from patients to help identify the mystery pathogen and sequenced the genetic code of what became the hepatitis C virus.
The final step in the effort came from Rice, then at Washington University in St Louis, who demonstrated that the virus alone could cause hepatitis, explaining the remaining infections spread by blood transfusions. The advent of sensitive tests for hepatitis C and antiviral drugs to treat the infection soon followed, saving millions of lives.
“The discovery was crucial in defining the fact that there was this other virus that was so important, particularly for transfusion-related infections,” said Graham Cooke, NIHR professor of infectious diseases at Imperial College London. “Since then we’ve seen a tremendous explosion in our understanding of the virus, to the point that we are now talking about eliminating hepatitis C.”
The physics prize will be announced on Tuesday and the prize for chemistry on Wednesday, both from the Royal Swedish Academy of Sciences.