A reduction in selective immune pressure during the course of chronic hepatitis C correlates with diminished biochemical evidence of hepatic inflammation

Kousuke Hanada, Yasuhito Tanaka*, Masashi Mizokami, Takashi Gojobori, Harvey J. Alter

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


It is considered that selection pressure exerted by the host immune response during early HCV infection might influence the outcome of that infection particularly as it relates to persistence or clearance of the agent. However, it is unclear whether positive selection pressure plays a role in determining the severity of hepatitis C during the course of persistent HCV infection. To address the evolutionary mechanism by which HCV escapes from the host immune response and to assess the relationship between viral evolution and hepatic inflammation, we determined 57 sequences (3-5 serial samples per patient) from 5 individuals with persistent HCV infection of genotype 1a who were under long-term follow-up ranging from 15.6 to 21.6 years. We applied a novel method to estimate serial alternations of selective pressure against the HCV enveloped region and compared this to fluctuation in transaminase level over time. Positive selection pressure was reduced over time postinfection, as evidenced by a reduction in nonsynonymous substitutions in the later phase of infection. Furthermore, serum transaminase, as a measure of inflammatory necrosis of hepatocytes, was reduced in parallel with decreased positive selection pressure. These results suggest that during persistent HCV infection, the virus faces diminished immune pressure over time, either from mutation to an immune resistant sequence or from immunologic exhaustion, and that this diminished immune attack is reflected in diminished inflammatory activity. This observation may be applicable to other viruses characterized by a slow rate of disease progression.

Original languageEnglish (US)
Pages (from-to)27-33
Number of pages7
Issue number1
StatePublished - Apr 25 2007


  • Alanine aminotransferase (ALT)
  • E2
  • Evolution
  • HCV
  • Immune response
  • Persistent infection
  • Positive selection
  • RNA virus
  • Selective pressure

ASJC Scopus subject areas

  • Virology

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