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The hepatitis C virus (HCV) is a remarkably successful pathogen, establishing persistent infection in more than two-thirds of those who contract it. Its success is related to its abilities to blunt innate antiviral pathways and to evade adaptive immune responses. These two themes may be related. We propose that HCV takes advantage of the impaired innate response to delay the organization of an effective adaptive immune attack. The tolerogenic liver environment may provide cover, prolonging this delay. HCV's error-prone replication strategy permits rapid evolution under immune pressure. Persistent high levels of viral antigens may contribute to immune exhaustion. Finally, the virus may benefit from the efficient enlistment of memory T and B cells in the pursuit of a moving target.

Original publication

DOI

10.1146/annurev.immunol.25.022106.141602

Type

Journal article

Journal

Annu Rev Immunol

Publication Date

2007

Volume

25

Pages

71 - 99

Keywords

Animals, B-Lymphocytes, Evolution, Molecular, Hepacivirus, Hepatitis C, Hepatitis C Antigens, Humans, Immune Tolerance, Immunity, Innate, Immunologic Memory, Liver, T-Lymphocytes, Virus Replication