From the 1940s to 1960s, two types of hepatitis were known to researchers …infectious and serum. A third type was unknown. From the 1930’s and earlier, an assortment of names confused everyone. Old names for HBV included serum hepatitis, homologous hepatitis, long incubation hepatitis, and Dane’s particle. HAV’s old names included infectious hepatitis, epidemic hepatitis, short incubation hepatitis.
The history of blood transfusions and blood banking really begins in earnest during the 1940’s (LINK to Red Cross timeline) and hepatitis was a problem for recipients, military and civilian. The good news is that after about 1995, hepatitis transmissions from blood transfusions (in the U.S.) dropped to almost zero (1-minute video Dr. Alter).
“…serum hepatitis emerged as a major hazard of blood transfusion among surviving battlefield casualties of World War II…it took nearly 3 decades before the hepatitis B virus, then termed the serum hepatitis virus, was identified and a blood screening test developed. This arduous path from observation to discovery culminated in the serendipitous finding of the Australia antigen in 1963.1“
1965–First major breakthrough (LINK to abstract). : Baruch Blumberg (1925-2011) and Harvey J. Alter discovered a red antigen, which, writes Alter, “…would unravel a hepatitis mystery that dates to early descriptions by Hippocrates.” The red antigen was called the Australia (Au) antigen and lastly, the hepatitis B surface antigen (HBsAg). By 1970, blood donor screening/diagnostic assays for hepatitis led to a 70% drop in transfusion-associated hepatitis (THA). Next came a hepatitis B vaccine.
In 1973, hepatitis A was visualized/discovered by Stephen Feinstone, Albert E Kapikian ( d.2014), and Robert Purcell. Hepatitis A: detection by immune electron microscopy of a viruslike antigen associated with acute illness. Science. 1973 Dec 7;182(4116):1026-8. (LINK) (More info LINK: Koff)
But patients were still getting post transfusion hepatitis and HAV was not the cause. Retrospective testing later showed that roughly 20%- 25% of TAH was hepatitis B–related, leaving 75%-80% of cases tentatively classified as non-B hepatitis.
1976: NANBH was diagnosed–by exclusion: Viral Hepatitis: New Aspects of an Old Disease (LINK)
1978 Non-A, Non-B Hepatitis (LINK to Feinstone/Purcell abstract )
Less than 20% of post transfusion hepatitis is due to HBV if only blood from voluntary donors that has been screened by third generation tests for the presence of hepatitis B surface antigen is used for transfusion. Type A hepatitis rarely, if ever, results from blood transfusion.1,2 Thus, most transfusion-associated hepatitis in the United States has an unknown cause.
1989: Next huge discovery came from Michael Houghton’s lab. Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome (Link to abstract Q L Choo et al/Chiron.) Daniel W. Bradley is another name one sees frequently; he says in the 2-minute video that the discovery actually took place two years earlier.
Hepatitis C virus: the major causative agent of viral non-A, non-B hepatitis. (LINK to abstract).
Blood screening followed and the blood supply was HCV-clean after about 1992 ( in the U.S..) preventing millions of infections.
Note: Dr. Purcell and collaborators also discovered the distinct strains of D and E. Good NIH interview (2005) transcript on of early human experiments and more background information is here in a less formal, more personal manner. ****
So hepatitis discoveries were in this order: HBV was discovered first and then HAV. Then HCV.
These scientists and their co-workers have spent untold hours of their lives working on these urgent problems and have made the world a better place by doing so. Those still living are still working and teaching. May they live another 25 productive years! Thank you for your discoveries and hard work for humanity.