HCV and HCC: clinical update and a review of HCC-associated viral mutations in the core gene.

Hepatocellular carcinoma (HCC) is a common cause of cancer-related mortality. The worldwide incidence of HCC and the hepatitis C virus (HCV) has increased over several decades suggesting an etiologic link. Progress has been made recently in several fields related specifically to HCV and HCC. The epidemiology has been better characterized, surveillance and treatment programs have been instituted, and data have emerged detailing the effect of other risk factors for HCC in patients with HCV. Studies of HCV-related HCC suggest differences in oncogenic potential according to genotype and mutations in the viral sequence. These same mutations are associated with interferon treatment failure, insulin resistance, and expression of HCV minicore proteins. These viral mutations provide a focus for investigations into the molecular basis of HCV-related oncogenesis, which may lead to improved diagnostic tests for early (curable) HCC and to interventions to prevent, and/or greatly retard, the oncogenic process.