Additionally, increases in the levels of proinflammatory mediators, such as tumor necrosis factor (TNF)-α, inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), and interleukin-1(IL-1), caused by HCV infection are known to increase the risk of HCC [43]. This evidence concerns the gene PTGS2 and hepatocellular carcinoma.