Since lower plasma HCV RNA levels were observed among patients infected with HCV carrying higher substitutions in PKR-bd and carrying INS/DEL in ISDR, our hypothesis is that the mutated PKR-bd virus trapped in hepatocytes might indirectly determine a role in hepatocyte damage that could trigger a process of degeneration in HCC. This evidence concerns the gene EIF2AK2 and hepatocellular carcinoma.