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Joan Stephenson, PhD

JAMA. 2000;283:2514.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

For some people, acute infection with hepatitis C virus (HCV) leads to chronic illness; for a lucky minority—about 15% of those infected—a full recovery follows. Now, a new study published in the April 14 issue of Science indicates that events that take place soon after primary infection determine whether patients succeed in clearing virus from the body or whether they become chronically infected.

In the study, researchers at the National Institutes of Health, the University of Cagliari in Italy, and other institutions analyzed how viral genes coding for proteins that coat the surface of the virus evolved in patients who became infected with HCV from blood transfusions. Changes in surface proteins enable the virus to evade attack by the immune system.

The investigators found that in patients who successfully eliminated the virus, the surface protein genes remained relatively unaltered after the initial immune response. In contrast, the . . . [Full Text of this Article]