The hepatitis C community woke up to great excitement on the morning of October 5, 2020. A flurry of tweets, texts and e-mails shared the news that the 2020 Nobel Prize in Physiology or Medicine had been jointly awarded to Dr. Michael Houghton (University of Alberta, Canadian Network on Hepatitis C), Dr. Harvey J. Alter (U.S. National Institutes of Health) and Dr. Charles M. Rice (The Rockefeller University) for their roles in the discovery of the hepatitis C virus.
This award spotlights the incredible impact these notable researchers have had on the advancement of hepatitis C research and care. Their breakthrough work has laid the foundation for what has proven to be a rapidly evolving and dynamic field. From discovery to effective treatment, the past 30 years have shown a marked improvement of testing for and treatment of hepatitis C. Although there is still work to do, it is important to acknowledge this medical milestone and look back on the history of hepatitis C to date.
Hepatitis C milestones – A brief history
Hepatitis C is curable, but it hasn’t always been. The circumstances in which we understand and aim to address hepatitis C have been fast moving. Since the landmark discovery of the virus in 1989, the landscape of hepatitis C treatment has shifted remarkably over the past 30 years.
- 1975: Hepatitis C is first described as ‘non-A, non-B hepatitis’, a disease caused by an unknown blood-borne virus linked to infected blood or blood products (transfusions).
- 1989: Fourteen years later, a breakthrough: the virus is discovered through the collaborative efforts of Drs. Houghton, Alter, Rice and their colleagues, and given the name ‘hepatitis C’.
- 1991: Hepatitis C becomes a notifiable disease in Canada and the first treatment option (alpha interferon) is approved for public use.
- 1992: The development of a more sensitive screening test allows for the screening of blood donations for hepatitis C, eliminating hepatitis C transmission through the blood supply in Canada.
- 1999: Health Canada approves the first combination of alpha interferon and ribavirin for the treatment of hepatitis C. While a positive step forward, this form of treatment is not perfect. Interferon requires a year-long course of weekly injections, meaning a person is involved in a difficult course of treatment for a lengthy period of time. Furthermore, the treatment has many side effects (including flu-like symptoms) and only cures roughly 40 percent of those who take it.
- 2003: The first clinical studies of a hepatitis C protease inhibitor take place in Montreal, Canada.
- 2010: July 28 is endorsed by the World Health Organization as World Hepatitis Day.
- 2011: Two new medications are approved to treat genotype 1 of hepatitis C. Soon to be known as direct-acting antivirals or ‘DAAs’, these treatments target the virus directly and interrupt its ability to replicate itself.
- 2014 – 2017: Health Canada approves additional new drugs and drug combinations. The approval of sofosbuvir and Harvoni in 2015 provides the first broad access to interferon-free regimens in the country. New treatments are 95 percent effective for all patient groups, as well as shorter in duration, better tolerated and taken orally.
- 2016: Canada commits to be part of the global effort to eliminate hepatitis C as a public health threat by 2030, signing on to the World Health Organization’s Global Health Sector Strategy on Viral Hepatitis.
- 2017: Health Canada approves the use and sale of a point-of-care hepatitis C antibody test and peg-interferon is discontinued for use in Canada for treating hepatitis C.
- 2018: A vast improvement in access to treatment. Before 2018, access to and funding for treatment in Canada was restricted based on the amount of liver damage or injury. These restrictions are lifted by all jurisdictions in order to improve access, changing the landscape of treatment.
- 2019: The Canadian Network on Hepatitis C (CanHepC) releases the Blueprint to Inform Hepatitis C Elimination in Canada.
- 2020: The 2020 Nobel Prize in Physiology or Medicine is jointly awarded to Dr. Michael Houghton, Dr. Harvey J. Alter, and Dr. Charles M. Rice, for their roles in the discovery of the hepatitis C virus.
Review the full history of hepatitis C here.
Looking ahead in the timeline
In 2011, it was estimated that 44 percent of people living with chronic hepatitis C infection in Canada were unaware of their status. Curing hepatitis C has major health benefits and reduces mortality, but many people with chronic hepatitis C in Canada remain undiagnosed and untreated.
With the tools to eliminate hepatitis C at our disposal, efforts to eliminate the virus have shifted from finding a cure to improving prevention services, scaling up testing and linking people to treatment and ongoing care.
The Blueprint to Inform Hepatitis C Elimination in Canada provides a framework and path forward. As we set our sights on elimination by 2030, the next 10 years will be sure to deliver unforeseen challenges, innovations and insights. These lessons to be learned can be further milestones on the road to elimination.
Shannon Elliot is CATIE’s knowledge specialist in hepatitis C.
Image taken from © Nobel Media