Immune complex (IC) frequently exists in sera of patients with hepatitis C virus (HCV) infection. When circulating HCV particles are fractionated by differential flotation ultracentrifugation, HCV in the bottom fraction appears to be in the form of I'C. Flotation ultracentrifugation of serum was done in 7 patients positive for serum anti-C3d-binding circulating IC and in 7 negative patients. In all IC-positive patients, HCV RNA was detected in the bottom fraction but not in the top fraction of 3 patients. Amino acid sequences of hypervariable region (HVR) of HCV in the bottom fraction of IC-positive patients were almost the same as those of whole serum, while those of the top fraction considerably differed from those of whole serum except for 1 case. These data suggest that the major population of HCV forms IC in IC-positive patients, and antibody response to the HVR of HCV is responsible for IC formation.