Charles M. Rice, a virologist and elected Fellow of the American Association for the Advancement of Science, has received the 2020 Nobel Prize in Physiology or Medicine along with two colleagues for contributions to the discovery of the virus that causes Hepatitis C.
An infection characterized by liver inflammation, Hepatitis C can lead to health issues including liver damage, liver cancer and death. Between the early 1970s and late 1990s, the three laureates — Rice, Harvey J. Alter and Michael Houghton — identified the virus that causes the infection, showed that it alone could lead to liver disease, and developed a screening test to prevent it from spreading during blood transfusions. Their discovery also laid the groundwork for the rapid development of antiviral drugs that can now cure approximately 95% of Hepatitis C patients.
“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 Nobel committee said in its announcement this morning. “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.”
Hepatitis can be caused by factors ranging from heavy alcohol use to autoimmune diseases. Most often, however, hepatitis occurs as the result of viral infections.
By the 1940s, researchers had determined that there are two types of viral hepatitis, one transmitted through contaminated water or food and the other through blood or bodily fluids. The first, now known as Hepatitis A, causes illness for a few weeks to a few months, usually with no lasting health effects.
The blood-borne viruses, now known as Hepatitis B and C, pose a more serious threat, as they can lead to chronic liver damage and liver cancer. Additionally, people are often unknowingly infected for years before complications arise. Two-thirds of Americans with Hepatitis B and half of those with Hepatitis C do not know that they are infected, according to the Centers for Disease Control and Prevention.
Following the discovery of the Hepatitis B virus in the 1960s, researchers developed an effective vaccine and diagnostic tests to prevent it from spreading through blood donations. While working at the National Institutes of Health in Bethesda, Maryland, Alter noticed that many patients who had received blood transfusions were continuing to develop chronic hepatitis. His studies throughout the 1970s showed that the patients were not contracting Hepatitis A or B, but an unknown virus.
For more than a decade, virologists failed to isolate the mystery virus. Eventually, Houghton and colleagues at Chiron, a California-based pharmaceutical firm, created the first clone of the virus by extracting DNA fragments from the blood of an infected chimpanzee. Publishing their results in Science in 1989, the team referred to the virus as Hepatitis C.
In the late 1990s, a group led by Rice at Washington University in St. Louis set out to confirm that the Hepatitis C virus alone could cause infection and liver disease. When the researchers genetically engineered an RNA variant of the virus and injected it into the liver of chimpanzees, changes resembling those in humans with the chronic disease occurred. Their study, also published in Science, provided final proof for the origin of the unexplained cases of hepatitis.
“Rice’s work, especially that shown in the 1997 Science paper, proved for the first time that the Hepatitis C RNA genome was sufficient to cause disease,” said Holden Thorp, editor-in-chief of the Science family of journals. “This discovery had profound implications for hepatitis itself, but also for our understanding of RNA viruses in general.”
The advancements made by the three awardees paved the way for today’s highly sensitive blood tests that can prevent the spread of Hepatitis C during blood transfusions, as well as antiviral medicines that can cure the disease. Yet, such testing and drugs are not prevalent in all parts of the world: World Health Organization data show that blood-borne hepatitis continues to kill about 1.4 million people each year.
Born in Sacramento in 1952, Rice earned his Ph.D. in biochemistry from the California Institute of Technology in 1981. He served as scientific and executive director of Rockefeller University’s Center for the Study of Hepatitis C from 2001 to 2018, and he remains a professor there. The AAAS Council elected him a Fellow in 2004.
“I am absolutely stunned,” Rice said in an interview with Nobel Media this morning. “When you get a call like this and you’re not expecting it, you pretty much don’t know what to say.”
“We don’t engage in these activities to win prizes,” he added. “I feel as though I’m a representative of the molecular virologist community that contributed something to the fight against this disease.”