Chronic infection with the hepatitis C virus (HCV) is associated with increased risk for hepatocellular carcinoma (HCC). Chronic immune-mediated inflammation is likely to be an important factor in the development of HCV-associated HCC, but direct effects of HCV infection on the host cell cycle may also play a role.Although overexpression studies have revealed multiple interactions between HCV-encoded proteins and host cell cycle regulators and tumor suppressor proteins, the relevance of these observations to HCV-associated liver disease is not clear. We determined the net effect of these interactions on regulation of the cell cycle in the context of virus infection. Flow cytometry of HCV-infected carboxyfluorescein succinimidyl ester-labeled hepatoma cells indicated a slowdown in proliferation that correlated with abundance of viral antigen. A decrease in the proportions of infected cells in G 1 and S phases with an accumulation of cells in G 2 /M phase was observed, compared to mock-infected controls. Dramatic decreases in markers of mitosis, such as phosphohistone H3, in infected cells suggested a block to mitotic entry. In common with findings described in the published literature, we observed caspase 3 activation, suggesting that cell cycle arrest is associated with apoptosis. Differences were observed in patterns of cell cycle disturbance and levels of apoptosis with different strains of HCV. However, the data suggest that cell cycle arrest at the interface of G 2 and mitosis is a common feature of HCV infection.Chronic infection with hepatitis C virus (HCV) is associated with an increased risk for hepatocellular carcinoma (HCC) (8). Typically, cancer only develops after several decades of infection. Although the incidence of newly acquired HCV infections has decreased over the past 20 years, the incidence of HCVassociated HCC is increasing significantly as the infected population ages. Liver cancer associated with chronic HCV infection will, thus, be a significant public health burden for years to come. A greater understanding of the mechanisms by which chronic HCV infection leads to HCC will be critical for the development of improved therapies.HCV has high genetic diversity and has been classified into six major genotypes that differ in their geographical distributions and natural history (33). Globally, infection with genotype 1 is the most common. Currently, only the genotype 1 and 2 HCV genomes have been propagated in cell culture.The mechanisms by which HCV infection leads to HCC are unclear. HCV has an RNA genome with an exclusively cytoplasmic life cycle. Since HCV-associated HCC typically develops in the setting of fibrosis and cirrhosis, HCC development may be driven at least in part by chronic immune-mediated inflammation. However, in vitro studies have revealed multiple interactions between HCV-encoded proteins and host cell cycle regulators and tumor suppressor proteins (24). For example, in vitro studies have shown that three distinct HCV proteins, core (13), NS3 (12), and NS5A (14,20,29), in...