Hepatitis C Virus has recently attracted attention again, with the 2020 Nobel Prize for Medicine going to three scientists who discovered HCV.

The movement to combat hepatitis C is active worldwide. In Korea, however, it will not be possible to achieve the eradication until 2040, 10 years later than the World Health Organization (WHO)’s target year of 2030, experts here say.

A researcher holds a hepatitis C vial. (Getty's Image)
A researcher holds a hepatitis C vial. (Getty's Image)

The Nobel Prize committee announced on Monday that Harvey Alter, vice president of the National Institutes of Health (NIH), Michael Houghton, a professor at the University of Alberta in Canada, and Charles Rice, a professor at Rockefeller University in the U.S., as nominees for the recent Nobel Prize for Medicine this year.

Dr. Alter discovered that viruses other than hepatitis A and B could cause hepatitis while studying the outbreak of hepatitis in patients who received blood transfusions in the mid-1970s. Professor Houghton was the first to identify the presence of HCV in infected chimpanzee blood, while Professor Rice revealed the internal protein structure of HCV for the first time, confirming that the presence of the virus alone can cause hepatitis.

The hepatitis C virus, which is attracting renewed attention with the Nobel Prize, is an RNA-based virus and is one of the viruses with severe genetic variation.

HCV is an infectious disease hard to prevent and manage because developing a preventive vaccine is difficult due to severe genetic variation caused by mutation. More than 170 million people are infected with HCV worldwide, and about 350,000 to 500,000 people die from diseases related to hepatitis C each year.

However, the treatment environment for hepatitis C has developed drastically over the past five years. It has become an infectious disease on the verge of eradication only 30 years after discovering HCV in 1989.

A direct-acting antiviral agent (DAA), an oral treatment that could completely cure the disease, was developed in 2014. Since then, treatment for the disease has gradually grown. Its treatment success rate is close to 100 percent with only eight weeks of treatment regardless of the hepatitis C virus ranging from genotype 1 to 6.

Due to the characteristics of the hepatitis C disease, the WHO has been calling for establishing a national policy aimed at eradicating the disease worldwide by 2030.

In response, various countries, such as the U.S., Taiwan, Japan, and France, are implementing health policies, including rapid national screening and treatment support, to achieve the WHO goals.

In particular, Taiwan supports hepatitis C screening and treatment for adults over the age of 45 at the national level and has expressed its intention to achieve eradication by 2025, five years earlier than the WHO's target year.

Amid the global movement to combat hepatitis C, the recent European Association for the Study of the Liver 2020, which took place from Aug. 27- 29, used Markov's disease progression models to evaluate the progress of hepatitis C virus removal in 45 high-income countries, drawing worldwide attention.

The study results showed that out of 45 high-income countries, only 11, or 24 percent, will achieve the WHO's goal of eradicating hepatitis C in 2030. The researchers predicted that five countries, including Korea, will complete it by 2040, a decade later than the WHO's mandated goals.

The research said this is because the treatment rate for hepatitis C in Korea has been decreasing recently, and the surveillance test plan for the initial diagnosis is insufficient compared to other countries.

According to the Korean Association for the study of the Liver (KASL), the nation has to treat 11,600 patients annually to eliminate hepatitis C by 2030. However, it has been only about three years since Korea started the hepatitis C transmission monitoring system. There is still a risk of large-scale transmission as the infected and spreaders are not properly identified.

Since early 2010, there have been calls for including hepatitis C screening in the transitional life screening, a service that promotes health through treatment and management through the early detection of chronic diseases and health risk factors by introducing customized health checkups suitable for gender and age characteristics for the people in the transition period. However, the government did not accept such requests.

A massive hepatitis C outbreak has occurred, starting with one at the Dana Clinic from 2015 to 2016, followed by an outbreak at the Hanyang Orthopedic Clinic.

The continuous outbreak led to a discussion on preparing measures at the national level. However, it has yet to be included in the national examination, as there were no policy changes.

The government said that it would continue to conduct a second pilot project until next year and reexamine the grounds for introducing the national examination after that.

The KASL had steadily pointed out that new measures are needed in the examination and treatment to eradicate hepatitis C by 2030 as the Korean health authorities lack practical and specific goals and implementation plans at the national level.

"Since the hepatitis C virus was first identified in 1989, rapid progress in diagnosis and treatment has been made," KASL President Lee Han-ju said. "Nowadays, it can be cured within two to three months with a once-a-day drug. As a result, it has become hopeful hepatitis that the world's major countries have set the goal of eradicating from the planet by 2030.”

Lee stressed that the Nobel Prize nomination would lead the global effort against hepatitis C, resulting in eradicating the virus.

"The KASL will also do its best so that Korea can also eradicate hepatitis C by 2030," Lee said.

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