Interactions between hepatitis C virus (HCV) and lipoproteins in humans play an important role in the efficient establishment of chronic infection. Apolipoprotein E (ApoE) on the HCV envelope mediates virus attachment to host cells as well as immune evasion. This interaction is thought to occur in hepatocytes, as ApoE plays dual functions in HCV assembly and maturation as well as cell attachment. In the present study, we found that secreted ApoE (sApoE) can also bind to viral particles via its C-terminal domain after HCV is released from the cell. Furthermore, the binding affinity of interactions between the sApoE N terminus and cell surface receptors affected HCV infectivity in a dose-dependent manner. The extracellular binding of sApoE to HCV is dependent on HCV envelope proteins, and recombinant HCV envelope proteins are also able to bind to sApoE. These results suggest that extracellular interactions between HCV and sApoE may potentially complicate vaccine development and studies of viral pathogenesis.IMPORTANCE End-stage liver disease caused by chronic HCV infection remains a clinical challenge, and there is an urgent need for a prophylactic method of controlling HCV infection. Because host immunity against HCV is poorly understood, additional investigations of host-virus interactions in the context of HCV are important. HCV is primarily transmitted through blood, which is rich in lipoproteins. Therefore, it is of interest to further determine how HCV interacts with lipoproteins in human blood. In this study, we found that secreted ApoE (sApoE), an exchangeable component found in lipoproteins, participates in extracellular interactions with HCV virions. More significantly, different variants of sApoE differentially affect HCV infection efficiency in a dose-dependent manner. These findings provide greater insight into HCV infection and host immunity and could help propel the development of new strategies for preventing HCV infection.KEYWORDS CRISPR-Cas9, hepatitis C virus, infectivity, secreted apolipoprotein E, envelope protein A pproximately 170 million people are chronically infected with hepatitis C virus (HCV) worldwide (1). Most HCV infections become chronic in humans and can progress to hepatic fibrosis, cirrhosis, or even hepatocellular carcinoma (2). This process is normally accompanied by high morbidity due to extrahepatic manifestations, including mixed cryoglobulinemia, diabetes mellitus, and atherosclerosis (3). In most developing countries, the current standard treatment for chronic hepatitis C is a combination of pegylated interferon with ribavirin (4), although unfortunately, the effects are unsatisfactory. Recently, highly efficacious directacting antiviral drugs (DAAs) have been approved; however, their clinical benefits