The induction of strong cytotoxic T-lymphocyte (CTL) and humoral responses appear to be essential for the elimination of persistently infecting viruses, such as hepatitis C virus (HCV). Here, we tested several vaccine regimens and demonstrate that a combined vaccine regimen, consisting of HCV E2 DNA priming and boosting with recombinant E2 protein, induces the strongest immune responses to HCV E2 protein. This combined vaccine regimen augments E2-specific immunoglobulin G2a (IgG2a) and CD8؉ CTL responses to a greater extent than immunizations with recombinant E2 protein and E2 DNA alone, respectively. In addition, the data showed that a protein boost following one DNA priming was also effective, but much less so than those following two DNA primings. These data indicate that sufficient DNA priming is essential for the enhancement of DNA encoded antigen-specific immunity by a booster immunization with recombinant E2 protein. Hepatitis C virus (HCV) is a major causative agent of non-A, non-B hepatitis (7,18). Previous studies indicate that the development of chronic liver disease and hepatocellular carcinoma is closely associated with persistent infection of HCV (30). Currently, the lack of efficient antiviral treatment against HCV makes the development of a vaccine highly desirable. It is unclear which type of immunity is essential for HCV resolution. Recombinant protein vaccination facilitates strong antibody responses and stimulates primarily Th2 cells, which are defined by their secretion of the cytokines interleukin-4 (IL-4), IL-5, and IL-10. Protein vaccination with HCV envelope glycoproteins E1 and E2 induced protective immunity against homologous virus challenge in chimpanzees (8). In this model, the protection appeared to be correlated to the titers of anti-E2 antibodies, suggesting that antibody responses are important for protection against HCV infection. Furthermore, there are growing evidences that Th1 and cytotoxic Tlymphocyte (CTL) responses to HCV proteins may play a key role in virus resolution during natural infection (9,11,24,28). It has been reported that the prevalent cytokine pattern of circulating HCV-specific CD4 ϩ T cells is Th1-like in patients who recovered from acute hepatitis, as exhibited by the secretion of IL-2 and gamma interferon (11). In addition, chimpanzees which generated high levels of CTL responses to HCV proteins eliminated HCV infection (9). Thus, an effective HCV vaccine must elicit both strong humoral and cell-mediated immune responses, especially Th1 and CTL responses.Since it has been documented that DNA immunization preferentially induces Th1 immunity and CTL responses to many viral antigens (5, 26, 36), DNA vaccine approaches have been applied to generate protective immunity to a variety of pathogens (10, 12, 33). However, DNA immunization was also demonstrated to generate weaker antibody and CTL responses than did protein and live attenuated vaccinations, respectively (22, 32). In general, immunity generated by DNA vaccination alone appeared to be sufficient to prot...