In addition, 100 HCV-infected patients who did not develop HCC, even after 15 years of follow-up, served as a control group. All patients were confirmed for CHC by liver biopsy and there was no significant difference in viral load between the two groups. The study outcome led the authors to propose that patients infected with HCV isolates with core-Gln70 and NS3-Tyr1082/Gln1112 have a

higher risk to develop HCC compared to those who lacked these residues. HCV core protein is the main structural component of the viral nucleocapsid 3-MA concentration and has also been proposed to be involved in a wide array of functions such as modulating viral and cellular gene expression, host signaling pathways, and lipid metabolism.[15] Amino acid residues at position 70 and 91 in the core protein have been associated with the outcome see more of the standard of care (SOC) treatment, specifically

in Japanese patients infected with HCV 1b. A few studies have also suggested a correlation between polymorphism at positions 70 and 91 of core protein (HCV 1b) and progression to HCC.[16, 17] The present study clearly demonstrates a greater propensity of HCV 1b isolates with core-Q70 and NS3-Y1082/Q1112 residues to cause HCC. How does the expression of core-Gln70 and NS3-Tyr1082/Gln1112 proteins contribute to HCC? Viral proteins are multifunctional, therefore perturbed interactions with signaling molecules, resulting in out-of-order signaling pathways, can be anticipated. Interestingly, a recent study found that the substitution pattern in the HCV 1b-core region does influence very early viral dynamics during the treatment (SOC plus telaprevir).[18]

The amino acid residues in the NS3 protease at positions 1082 and 1112 reported in MCE this study are near the catalytic triad (His-1083, Asp-1107, and Ser-1165) of NS3-protease.[10] It has also been shown that the N-terminal protease domain of NS3 transforms cells in culture.[8, 11, 12] However, the mechanism by which these polymorphic viral factors could affect virus-host interactions, as a result initiate, and finally cause HCC, needs further investigation. These studies will also help to further understand the complex life cycle of HCV. Many interesting questions can be asked: for instance, could phosphorylation of Y residues have an impact on the NS3 (protease or helicase) activity? Could these modified or unmodified residues alter protein-protein or protein-nucleic acid interactions in hepatocytes? It would be interesting to investigate these questions further. NS5A is a proline-rich, RNA binding[19] zinc metalloprotein with three proposed structural domains (domain I, II, and III) which are separated by two low complexity sequences.[20] Owing to the high degree of conformational flexibility, domain II (DII) and domain III (DIII) are intrinsically disordered.