This article suggests a reason why hcv causes persistent infection. It is written in quite difficult scientific language but is is well worth reading. If this guy is right he deserves a nobel prize. Or two. Or how many do you want?
much of the worlds' population is in active or imminent danger of infection with established infectious pathogens, while sporadic and pandemic infections by these and emerging agents threaten everyone. Rna polymerases (rnapol) generate enormous genetic and consequent antigenic heterogeneity permitting viruses and cellular pathogens to evade host defences. Thus, rnapol causes more morbidity and premature mortality than any other molecule. The extraordinary genetic heterogeneity defining viral quasispecies results from rnapol infidelity causing rapid cumulative genomic rna mutation a process that, if uncontrolled, would cause catastrophic loss of sequence integrity and inexorable quasispecies extinction. Selective replication and replicative homeostasis, an epicyclical regulatory mechanism dynamically linking rnapol fidelity and processivity with quasispecies phenotypic diversity, modulating polymerase fidelity and, hence, controlling quasispecies behaviour, prevents this happening and also mediates immune escape. Perhaps more importantly, ineluctable generation of broad phenotypic diversity after viral rna is translated to protein quasispecies suggests a mechanism of disease that specifically targets, and functionally disrupts, the host cell surface molecules--including hormone, lipid, cell signalling or neurotransmitter receptors --that viruses co-opt for cell entry. This mechanism-- "viral receptor disease" --may explain so-called "viral autoimmunity", some classical autoimmune disorders and other diseases, including type ii diabetes mellitus, and some forms of obesity. Viral receptor disease is a unifying hypothesis that may also explain some diseases with well-established, but multi-factorial and apparently unrelated aetiologies--like coronary artery and other vascular diseases--in addition to diseases like schizophrenia that are poorly understood and lack plausible, coherent, pathogenic explanations.