Harvey J. Alter
National Institutes of Health
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Primary Section: 42, Medical Physiology and Metabolism Secondary Section: 41, Medical Genetics, Hematology, and Oncology Membership Type:
Member
(elected 2002)
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Research Interests
In my research on viral hepatitis and the safety of the blood supply, I have determined the incidence of transfusion-associated hepatitis, identified risk factors in the donor population that contribute to hepatitis transmission, and designed preventive strategies. These studies have led to adoption of an all-volunteer donor supply, the early use of hepatitis B virus screening, the identification of non-A, non-B hepatitis (NANBH), the use of surrogate markers (ALT, anti-HBc) to prevent NANBH transmission and proof that the cloned hepatitis C virus was the predominant cause of NANBH. These studies have contributed to a decline in hepatitis incidence from 30 percent in 1970 to near zero in 2000. These prospective studies are now focused on other infectious agents that can be blood transmitted, such as CMV, parvovirus B-19, and West Nile virus. Another interest has been in the history of hepatitis C virus infection and the virologic and immune mechanisms that lead to viral persistence. It appears that 20 percent of hepatitis-C-infected individuals clear the initial infection but that 80 percent have a virus-specific immune deficit that is insufficient to clear a virus that exists as a swarm of immunologically distinct variants (quasi species). Studies of the viral quasi species and cell-mediated immunity to the hepatitis C virus are vital to devising vaccine strategies. I am working on a DNA vaccine approach using lipid adjuvants and a recombinant protein boost.
