Dr. Harvey J. Alter, resident in the UW Internal Medicine Residency Program from 1964-65, receives the 2020 Nobel Prize for his contributions to the discovery of the Hepatitis C virus.

The Nobel Assembly at Karolinska Institutet announced yesterday that the 2020 Nobel Prize in Physics or Medicine was jointly awarded to Drs. Harvey J. Alter, Michael Houghton and Charles M. Rice for the discovery of Hepatitis C virus.

Hepatitis C, a virus that can cause liver inflammation, cirrhosis and eventual cancer and failure, is one of two of the hepatitis viruses that is transmitted through blood and bodily fluid. While Hepatitis A is transmitted by polluted water or food and generally has little long-term impact on the patient, hepatitis B and C are caused when blood infected with the virus is transmitted from person to person, and, if untreated, lead to long term complications and even death.

Dr. Harvey J. Alter in 2020
Dr. Harvey J. Alter in 2020. Credit - NIH/Chiachi Chang

Alter has centered his career on the study of hepatitis, inflammation of the liver. Alter trained at the University of Washington for residency in 1965 before fast-tracking to a hematology fellowship at Georgetown University.  In 1969, Alter joined the NIH Clinical Center’s Department of Transfusion Medicine as a senior investigator. Alter has spent over 50 years at the NIH Clinical Center, serving as chief of the infectious diseases section and associate director of research in the department of transfusion medicine.

While it has been understood since the 1940s that hepatitis can be transmitted in two different modalities, Alter’s work with Baruch Blumberg in the 1960s led to the discovery that a separate hepatitis virus, Hepatitis B, was responsible for some of the blood-borne infections. Alter continued his research at the NIH with patients who developed hepatitis after blood transmission, noticing that hepatitis occurred despite prior screening for presence of Hepatitis A and B viruses. Through testing and experiments, Alter and his team proved that transmission in these cases was due to a new unknown agent, known as “non-A, non-B” hepatitis.

Building on this research, Alter’s co-honorees Michael Houghton isolated the hepatitis C virus in 1989 and Charles Rice proved the virus alone was the cause of the “non-A, non-B” hepatitis cases in1997.

Fitting these pieces of the puzzle together, Alter and Houghton together developed the first screening test for presence of the hepatitis C virus in 1990, driving the incidence of post-transfusion hepatitis C down 200-fold over the following 7 years.

From the Nobel Assembly:

The Nobel Laureates’ discovery of Hepatitis C virus is a landmark achievement in the ongoing battle against viral diseases. 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. 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. To achieve this goal, international efforts facilitating blood testing and making antiviral drugs available across the globe will be required.