M ore than 4 million women and men in the United States and 150 million people worldwide are estimated to be hepatitis C virus (HCV) seropositive. 1,2 Most of these individuals are chronically infected with the virus and are at high risk of cirrhosis, hepatocellular carcinoma, and liverrelated death. The natural history of HCV infection, however, is highly variable. Some individuals do not become HCV infected despite high levels of exposure. 3 Other individuals may clear HCV RNA following acute infection, and whereas some individuals with long-term HCV viremia remain clinically asymptomatic, others have progressive disease. 4 Indeed, marked variability in natural history is seen even among groups of individuals with single-source exposure to HCV, as occurred in a population of Irish women exposed to HCV-contaminated anti-D immune globulin. 5 Together these observations suggest that host factors, particularly host immune response, play a key role in the regulation of HCV pathogenesis.