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Two Americans and a British scientist have won the 2020 Nobel prize in physiology or 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, announced on Monday by the Nobel assembly from the Karolinska Institute in Stockholm, is worth 10m Swedish kronor (£870,000), which will be shared among the winners.
“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,” the Nobel committee said.
Speaking of how he heard the news, 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.” Rice said he was “absolutely stunned” on receiving the call, adding “it is a success story for team science.”
The prize may prove controversial. In 2013, Houghton refused a major award for his hepatitis C work because it excluded two former co-workers, George Quo and Qui-Lim Choo who helped him identify the virus. Houghton, who received his PhD from King’s College London in 1977, said his colleagues did not get the recognition they deserved.
David Pendlebury, a citation analyst at Clarivate, a scientific data firm, said he was surprised the Nobel committee had made the award. “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 award threw into high relief the perennial issue of the Nobel’s rule of three, he added, where no more than three researchers can be named for discoveries that have often been team efforts.
Houghton accepted the Nobel but said he hoped future award committees would recognise larger groups of scientists. “Great science, often, is a group of people and I think going forward we somehow need to acknowledge that,” he said.
The scientists’ work transformed the understanding and treatment of hepatitis C, a virus that infects more than 70 million people, and kills 400,000 a year, 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.