Serial study of hypervariable region (HVR) of hepatitis C virus (HCV) in a case with spontaneous recovery from chronic hepatitis C

A case of chronic hepatitis C who recovered without any antiviral therapy is presented. During the clinical course, diversity in the HVR of the HCV genome was examined serially by the PCR-heteroduplex method. A 54-year-old man was admitted to our hospital with abnormal liver function in May 1990. Laboratory data showed that serum HCV-RNA and HCV Ab were positive, and HCV subtype was III/2a. Liver biopsy revealed chronic aggressive hepatitis (CAH2a). About 3 years later, liver function tests returned normal values, indicating the disappearnce of viremia. Serial study of the HCV quasispecies in the HVR confirmed that diversity in the HVR changed from multiple bands at the time of initial patient contact to a predominant band during the clinical course. These results support the hypothesis that changes in the HVR sequence may play an important role in persistent infection by HCV.