Concerned about "silent pandemic" | virologist who discovers hepatitis c wins 2020 nobel prize in physiology or medicine

Author: Ewen Callaway & Heidi Ledford Harvey Alter, Michael Houghton and Charles Rice were awarded this year's nobel prize in physiology or medicine for their work on a virus that kills hundreds of thousands of people each year. The 2020 nobel prize in physiology or medicine was awarded to three scientists who discovered and characterized the virus that causes a variety of hepatitis and liver disease cases—hepatitis c virus. The winners were Harvey Alter of the National Institutes of Health, Michael Houghton of the Canadian university of alberta, and Charles Rice of Rockefeller University in new york. Their work with the hepatitis c virus has paved the way for an effective treatment of infection. The world health organization (WHO) estimates that there are 71 million people worldwide with chronic hepatitis c virus, which causes nearly 400,000 deaths each year, most of them due to cirrhosis and liver cancer. Ellie Barnes, a researcher in liver medicine and immunology at the University of Oxford in the UK, said they deserved the award. "this is a reflection of the noble nature of science, and we have been able to cure most of those infected," she said. The three winners will share 10 million Swedish kronor (US$ 1.1 million) in the prize money. Blood borne pathogen In the 1970s, Alter studied the spread of hepatitis caused by blood transfusion. Previous studies have identified hepatitis a and hepatitis b viruses, but Alter has identified a third blood-borne pathogen and demonstrated that it can spread the disease to chimpanzees. Houghton, then at Chiron, California, and colleagues identified the virus based on genetic material from infected chimpanzees, proving that the new RNA virus belonged to the flaviviridae and named it hepatitis C virus. Rice, then at the University of Washington, led a team that used genetic engineering to characterize the portion of the hepatitis C virus genome responsible for viral replication and to elucidate its role in triggering liver disease. At a press conference, Alter said that Chiron researchers had taken six years to clone a small fragment of the hepatitis C virus genome, and he doubted whether the time-consuming and laborious research could be carried out today. He said: "Today, if you don't have a direct research endpoint, it is very difficult to obtain funding. For people nowadays, especially young people, research is becoming more and more difficult to do. I think this situation must be changed. " Some researchers thought that virologist Ralf Bartenschlager of the university of heidelberg in Germany should also be the candidate for the nobel prize for hepatitis c because he found a way to replicate hepatitis c virus in the laboratory. But Bartenschlager said the choice of the Nobel committee was reasonable. "it was really a difficult decision," he said. "i don't think they have much to say about this award." Houghton has been vocal in criticizing the limit on the number of winners in scientific awards; The highest number of nobel prize winners is three. In 2013, he rejected the prestigious Canadian Gairdner Award)—— a C $100,000 (US$ 75,000) prize—because it was not co-presented to his Chiron partners, Qui-Lim Choo and George Kuo. "he has always wanted his findings to be seen as a result of teamwork." Said Thomas Baumert, a virologist and liver pathologist at the university of strasbourg in france. Houghton said he had tried to convince the Gairdner Foundation to add his partner to the award list, but discussions with the Foundation intensified. Houghton finally decided to give up receiving the award. But he also said that the Nobel Prize is another matter. "i think if i refuse the nobel prize is too much. Their rules and procedures are based on the will of Alfred Nobel himself, and I do not think it is feasible to discuss this issue with them. " He said at the press conference. Vaccine dilemma The work of the three laureates and others has led to significant advances in hepatitis detection and treatment. In the past decade, painful and inefficient treatments have been replaced by drugs that block the virus directly. These drugs have the potential to cure the vast majority of hepatitis c infections, but high costs still make treatment difficult for those infected in many low-and middle-income countries. Treatment for hepatitis c require an 8-12 week regimen, Barnes said. "many people with hepatitis c are still in high-risk settings, some are intravenous drug users, which makes it difficult for infected people to get drugs." Bartenschlager said he hoped the Nobel Prize would draw attention to the "silent pandemic" of hepatitis C worldwide. Barnes thinks the WHO target of eliminating hepatitis C virus by 2030 can be achieved, but she says a vaccine may be needed. The development of such vaccines has been slow, in part because of inadequate funding and the volatile nature of the virus itself. The genetic differences between the different strains of hepatitis c virus are enormous: Barnes estimates that the diversity of hepatitis c virus is 10 times that of hiv and "countless times" that of SARS-CoV-2 in SARS-CoV-2. In addition, it is difficult to conduct clinical trials in the population most vulnerable to hepatitis C virus infection. These problems can be overcome, Barnes added. "the virus was discovered 30 years ago, but we still don't have a vaccine and people still die from hepatitis c.. From this point of view, the story is still not over. " Baumert added that advances in treatment have given people a misconception that the hepatitis C problem has been resolved and that funders and journals seem less interested. The nobel prize or an opportunity to remind the world that hepatitis c has not been cured. "hepatitis c will return to the public eye and refocus attention on vaccines," he said The original text was published in the news section of "Nature" on October 5, 2020 under the title of Virologists who discovered hepatitis c win medicine nobel.

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doi: 10.1038/d41586-020-02763-x