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A strong innate immune response against HCV during the acute phase is responsible for natural HCV clearance.54 Bench to bedside research has provided increasing evidence about the cross-talk between cholesterol and immunity.2,55 In the context of HCV infection, recently, cholesterol and its derivatives have emerged as immunomodulators that potentialize the innate immune response and may favor the natural or treatment-induced clearance of the virus.28,56 There is evidence that cholesterol promotes the formation of toll-like receptor (TLR) 4-MD2 and TLR4-CD14 complexes, which are responsible for recognizing lipopolysaccharides as part of the innate immune response.57 A study performed in an HCV-pro-ducing B-cell line derived from an HCV+ non-Hodgkins lymphoma, demonstrated that activation of TLR4 by HCV infection triggers the expression of IFN-beta and interleukin-6 (IL-6) in B cells.58 Since IL-6 leads inflammatory processes and IFN induces an antiviral state in HCV infection,59,60 these findings suggest that cholesterol can play an indirect role in HCV eradication by contributing to the hosts innate immune response

In addition to its role in metabolism, ALC exhibits antioxidant and anti-inflammatory properties, which help reduce excessive immune responses [158, 161]

The exact cause of CG is not known yet