H epatitis C virus (HCV) is one of the most important pathogens causing liver-related morbidity and mortality. 1 Hepatitis C is characterized by persistent infection of the liver, leading to the development of chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma. Type-I interferon (IFN) plays a central role in eliminating viruses, not only by way of therapeutic applications 2 but also as a natural cellular antiviral mechanism. 3,4 Interferons are produced naturally in response to virus infection and to cellular exposure to IFN itself. Binding of the IFNs to their receptors activates the Jak-STAT pathway to form a complex with IFN-stimulated gene factor-3 (ISGF3), which translocates to the nucleus, binds the IFN-stimulated response element (ISRE) located in the promoter/enhancer region of the IFN-stimulated genes (ISGs), and activates expression of ISGs.HCV subgenomic replicons constitute in-vitro models that simulate cellular autonomous replication of HCV

Gene alterations in TERT promoter, TP53, CTNNB1, and HBV integration were closely associated with HCC development, and mutations in TERT promoter are related to poor prognosis. These results are useful for understanding the underlying mechanism of hepatocarcinogenesis, diagnosis, and predicting outcomes of patients with HCC.

Hepatitis C virus (HCV) infection blocks cellular interferon (IFN)-mediated antiviral signaling through cleavage of Cardif by HCV-NS3/4A serine protease. Like NS3/4A, NS4B protein strongly blocks IFN-b production signaling mediated by retinoic acid-inducible gene I (RIG-I); however, the underlying molecular mechanisms are not well understood. Recently, the stimulator of interferon genes (STING) was identified as an activator of RIG-I signaling. STING possesses a structural homology domain with flaviviral NS4B, which suggests a direct protein-protein interaction. In the present study, we investigated the molecular mechanisms by which NS4B targets RIG-I-induced and STING-mediated IFN-b production signaling. IFN-b promoter reporter assay showed that IFN-b promoter activation induced by RIG-I or Cardif was significantly suppressed by both NS4B and NS3/4A, whereas STING-induced IFN-b activation was suppressed by NS4B but not by NS3/4A, suggesting that NS4B had a distinct point of interaction. Immunostaining showed that STING colocalized with NS4B in the endoplasmic reticulum. Immunoprecipitation and bimolecular fluorescence complementation (BiFC) assays demonstrated that NS4B specifically bound STING. Intriguingly, NS4B expression blocked the protein interaction between STING and Cardif, which is required for robust IFN-b activation. NS4B truncation assays showed that its N terminus, containing the STING homology domain, was necessary for the suppression of IFN-b promoter activation. NS4B suppressed residual IFN-b activation by an NS3/4A-cleaved Cardif (Cardif1-508), suggesting that NS3/4A and NS4B may cooperate in the blockade of IFN-b production. Conclusion: NS4B suppresses RIG-I-mediated IFN-b production signaling through a direct protein interaction with STING. Disruption of that interaction may restore cellular antiviral responses and may constitute a novel therapeutic strategy for the eradication of HCV. (HEPATOLOGY 2013;57:46-58)

ITPA SNP, rs1127354, is confirmed to be a useful predictor of ribavirin-induced anemia in Japanese patients. Patients with the ITPA minor variant A (~ 27%) have an advantage in pegylated interferon plus ribavirin-based therapies, due to expected adherence of ribavirin doses, resulting in a higher viral clearance rate.

Real-time monitoring of the serum M2BPGi level after antiviral therapy for CHC patients could be a helpful screening tool for assessing the risk of HCC. M2BP and its glycan structure could be associated together with hepatocarcinogenesis.