The presence of HCV induces aberrant expression of pro-inflammatory cytokines such as TNF-α, IL-1, IL-23, IL-6, and LT-α and LT-β that help to establish and maintain a state of chronic inflammation and which have been implicated in HCC progression [75,162,163], although, interestingly, elevated serum IL-6 levels are associated with an increased risk of HCC in females but not in males due to an estrogen-dependent effect of pro-inflammatory cytokines on HCC risk [75]. Here, TNF is linked to hepatocellular carcinoma.