Hepatitis C virus (HCV) is a liver tropic pathogen that affects ∼170 million people worldwide and causes liver pathologies including fibrosis, cirrhosis, steatosis, iron overload, and hepatocellular carcinoma. As part of a project initially directed at understanding how HCV may disrupt cellular iron homeostasis, we found that HCV alters expression of the iron uptake receptor transferrin receptor 1 (TfR1). After further investigation, we found that TfR1 mediates HCV entry. Specifically, functional studies showed that TfR1 knockdown and antibody blocking inhibit HCV cell culture (HCVcc) infection. Blocking cell surface TfR1 also inhibited HCV pseudoparticle (HCVpp) infection, demonstrating that TfR1 acts at the level of HCV glycoprotein-dependent entry. Likewise, a TfR1 small-molecule inhibitor that causes internalization of surface TfR1 resulted in a decrease in HCVcc and HCVpp infection. In kinetic studies, TfR1 antibody blocking lost its inhibitory activity after anti-CD81 blocking, suggesting that TfR1 acts during HCV entry at a postbinding step after CD81. In contrast, viral spread assays indicated that HCV cellto-cell spread is less dependent on TfR1. Interestingly, silencing of the TfR1 trafficking protein, a TfR-1 specific adaptor protein required for TfR1 internalization, also inhibited HCVcc infection. On the basis of these results, we conclude that TfR1 plays a role in HCV infection at the level of glycoprotein-mediated entry, acts after CD81, and possibly is involved in HCV particle internalization.hepatic iron overload | viral entry factor H epatitis C virus (HCV) infects more than 170 million people worldwide. Approximately 80% of infections persist to chronicity and can lead to liver pathologies including fibrosis, cirrhosis, steatosis, hepatic iron overload, and hepatocellular carcinoma. At this time, however, no vaccine is available to protect against infection, and current IFN-based treatment options, including those that include the HCV protease inhibitors recently approved for genotype 1 patients, are associated with toxic side effects and are only effective in a subset of patients (1, 2). As a result, in the United States, chronic HCV infection is the leading cause of hepatocellular carcinoma and the most common indication for liver transplantation. Importantly, identifying host factors and pathways involved in HCV infection could provide insight into HCVmediated liver disease and possibly lead to the discovery of novel therapeutic targets.Previous studies have reported that a disproportionate number of HCV patients develop hepatic iron overload, suggesting that iron metabolic pathways are deregulated during HCV infection (3-6). Consistent with this hypothesis, changes in the expression of iron metabolic genes have been reported in infected patients and in one HCV replicon cell clone (7,8). Following up on those studies, we initially observed that TfR1 mRNA and protein levels were down-regulated in human hepatoma Huh7 cells in response to HCV infection.TfR1 is the main receptor for cellular ir...