Preliminary studies have shown that hepatitis C virus (HCV) quasispecies populations after interferon therapy are different from those before interferon, suggesting that selection of HCV quasispecies occurs during IFN treatment. To confirm this, fluctuations of HCV quasispecies populations were investigated by single strand conformation polymorphism analysis in eight patients who remained viremic during interferon treatment. In all patients, HCV quasispecies populations changed in 1 to 4 months after the start of interferon therapy. In seven patients, a minor population of HCV quasispecies that was present before the interferon therapy was selected and became predominant during the therapy, whereas the abundance of the other quasispecies was reduced. In the other patients, new HCV quasispecies that had not been detected before interferon therapy appeared and replaced the pretreatment HCV. In contrast, no significant changes were observed during the pretreatment period in these patients. In two patients, deduced amino acid sequences of the hypervariable region were identical despite the difference in nucleotide sequences between interferon-sensitive and interferon-resistant HCV. Thus, selection of HCV quasispecies occurs during interferon treatment and immune responses to the hypervariable region may not be the determining factor of the selection.