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From B to Non-B to C: The Hepatitis C Virus in Historical Perspective

  • Harvey J. AlterEmail author
Chapter
Part of the Topics in Medicinal Chemistry book series

Abstract

The discovery of HCV was an evolutionary process beginning with the serendipitous identification of the Australia antigen that later proved to be the surface protein of the hepatitis B virus (HBV) and the first marker for any human hepatitis virus. Studies of transfusion-associated hepatitis made it evident that most cases were unrelated to HBV. The later discovery of the hepatitis A virus (HAV) made it apparent that non-B cases were also non-A leading to the awkward terminology non-A, non-B hepatitis (NANBH). While NANBH was identified only by exclusion and had no specific serologic or molecular marker, using chimpanzee transmission studies, it was possible to show that the NANBH agent was small and enveloped and most consistent with being a flavivirus as it later proved to be. Clinical studies showed that NANBH could lead to cirrhosis, hepatocellular carcinoma, and liver-related fatality. The major breakthrough occurred in the late 1980s when the Chiron Corporation cloned the NANBH agent and renamed it the hepatitis C virus (HCV). Adding HCV serologic testing, and later molecular testing, to routine donor screening virtually eradicated TAH with current risk estimated to be one case in two million transfusions. More recently, direct-acting antiviral agents have been shown to result in sustained virologic responses, tantamount to cure, in 98% of treated subjects. The existing challenges are to identify currently unrecognized HCV carriers and to make treatment accessible to all.

Keywords

Australia antigen HBV HCV Hepatitis B virus Hepatitis C virus NANBH NANBV Non-A Non-B hepatitis Posttransfusion hepatitis Transfusion-associated hepatitis 

Notes

Compliance with Ethical Standards

Ethical Statement: All patient studies described herein were performed under NIH IRB approved protocols with appropriate informed consent.

Chimpanzee studies were approved by the animal use committees of the Southwest Foundation for Biomedical Research, San Antonio Texas or the NIH, Intramural program.

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Copyright information

© This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2019

Authors and Affiliations

  1. 1.National Institutes of HealthBethesdaUSA

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