Strong epidemiological evidence links hepatitis C infection with hepatocellular carcinoma (
3). Liver cancer usually develops decades after HCV infection and liver cirrhosis. However, the molecular mechanisms involved in cancer development have not been fully understood. HCV is classified as a positive-strand RNA virus that replicates in the cytoplasm and does not integrate into the host DNA; however, its carcinogenic features are remarkable. It is possible that indirect mechanisms such as chronic liver inflammation, oxidative damages, presence of cirrhosis and DNA damage are involved in cancer development (
21,
22). Cirrhosis as the result of fibrosis due to hepatitis C infection is the indication of preneoplastic stage in development of liver cancer, which can cause rapid proliferation of dysplastic liver cells (
21). Studies have shown that HCV proteins, especially core protein, are inherently oncogenic and their expression in the cell can be involved in the development of HCC directly and in the absence of immune responses or cirrhosis. Several HCV proteins can interact with host cell proteins and induce cell proliferation. Evidence has shown that replication of HCV replicon RNAs is strongly dependent on cell proliferation (
23), while the HCV RNA synthesis is stimulated in the S phase of the cell cycle (
24). Hepatocytes usually have low proliferation rate and it seems that some viral proteins expressed during HCV infection trigger cell division and are involved in carcinogenic effects of chronic HCV infection (
22,
25).
A positive correlation between chronic HCV infection and HCC progression has been frequently reported. However, the main mechanisms underlying pathogenesis of HCV-induced HCC has remained unclear. We reported here molecular mechanisms regulated by HCV, which seem to be involved in HCC progression and invasion. We found that the
c-Jun gene is the most important hub gene obtained from topological analysis of both HCV and HCC networks. The
c-Jun has a key role in enhanced cell proliferation of cancer cells by regulating the expression of
CCND1 and
Cdc2 genes (
26). In addition,
c‐Jun can prevent
TNFα-mediated apoptosis through cooperation with
NFKB1. Erhadt and colleagues reported that HCV can protect various cells from
TNFα-induced apoptosis via activating
NFKB signaling pathway (
27). Taken together, we suggest that the role of HCV in the inhibition of apoptosis is mediated by c‐Jun function. Two proto-oncogene,
BCL2 and
ERBB2, were identified as the common hub genes of HCV and HCC-derived PPI networks. The
BCL2 overexpressing cells tend to have a prolonged survival and reduced apoptosis in a variety of cancer cells. This gene is highly capable of suppressing apoptosis by either inhibiting the release of cytochrome c from the mitochondria or blocking the function of
APAF1 (
28). It is now well established that HCV triggers cancer cell apoptosis and survival through up-regulation of
BCL2 expression, resulting in reduced
CASP3 activity. The nonstructural protein 4B (
NS4B) is the key gene responsible for stimulating
BCL2 gene through inhibition of the function of
SOCS3 gene (
29).
ERBB2 is a protein tyrosine kinase that can bind to other growth factor receptors to form a heterodimer, stabilizing ligand-receptor complex and enhancing several downstream signaling pathways such as mitogen-activated protein kinase (MAPK) and phosphatidylinositol-3 kinase (PI3K/Akt1) (
10,
30). This gene was identified as an important hub gene in both chronic HCV and HCC networks. The statistically significant correlation between
NS3, an HCV serine protease, and
ERBB2 has been reported in HCC cases (
31). VEGFC is an important gene involved in promoting angiogenesis. This hub gene was up-regulated in HCV and HCC samples compared to normal liver cells. It is now widely accepted that HCV is of central importance for vascular development and angiogenesis through enhancing the expression of
VEGFC (
32).
Extracellular matrix proteins play a pivotal role in tumor progression and their alterations are usually associated with an aggressive phenotype of various cancer types. Our results revealed that expression of
COL4A2,
COL1A1 and
COL5A1 hub genes were significantly altered in the HCV-infected and HCC cells compared to the normal cell samples. These genes are necessary for spreading HCC cells through remodeling of extracellular matrix (
33). Recently, it has been determined that HCV infection can lead to an increased invasive phenotype by regulating the matrix metalloproteinases (MMPs), a family of extracellular matrix components (
34). However, the role of HCV in regulation of collagen genes is poorly understood.
Amongst non-coding RNAs, the role of miRNAs in carcinogenesis has been extensively investigated. Varnholt and colleagues examined the miRNA gene expression profile of HCV-infected HCC cells and identified several important miRNAs that seem to be involved in the pathogenesis of HCV-associated HCC (
26). We found that the miRNA gene expression profile of HCV-infected cells is clearly similar to HCC cells. The
hsa-miR-155 and
hsa-miR-34a were down-regulated in both HCV-infected and HCC cells compared to the control samples. The HCV core and
NS5A proteins have been implicated in pathogenesis of HCC through induction of Wnt signaling pathway (
28). HCV-associated activation of Wnt signaling pathway may be mediated by expression alterations of
hsa-miR-34a and
has-miR-744. Additionally, the HCV can actively induce cell proliferation and MAPK signaling pathway in vitro (
27). However, the distinct mechanism defining the effect of HCV on the cell proliferation has remained unknown. Here, we show that HCV can positively impair cell cycle progression through inhibition of hsa-miR-34a. The expression of two cell proliferation-related genes, RRM2 and BIRC3, is regulated by
hsa-miR-34a (
Figure 4). This miRNA can activate the MAPK signaling pathway.
However, activation of MAPK, AKT1, NFKB1 and JAK-STAT signaling pathways is also mediated through down-regulation of
hsa-miR-155. This hub miRNA was significantly down-regulated in both HCV-infected and HCC cells compared to normal cells. However, functional study of
hsa-miR-155 targets revealed that down-regulation of this miRNA can induce cell proliferation and angiogenesis and inhibit apoptosis through activating aforementioned signaling pathways (
Figure 4). The
hsa-miR-24 acts as an anti-apoptotic miRNA by repressing the expression of
Bim gene (
35). We found that this hub miRNA was up-regulated in HCV-infected and HCC samples, suggesting its possible effect on the progression of HCC cells. Furthermore, the function of tumor suppressor
BRCA1 is considerably modulated by
hsa-miR-24. The
hsa-miR-92a is a key regulator of angiogenesis and apoptosis. It has been shown that overexpression of
hsa-miR-744 can moderately induce tube formation and reduce apoptosis in vitro (
36).