The hepatitis C virus (HCV) nonstructural NS5A protein has been shown to bind to and activate phosphoinositide 3-kinase (PI3K), resulting in activation of the downstream effector serine/threonine kinase Akt/ protein kinase B. Here we present data pertaining to the effects of NS5A-mediated Akt activation on its downstream targets. Using a recombinant baculovirus to deliver the complete HCV polyprotein to human hepatoma cells in a tetracycline-regulable fashion, we confirm that expression of the complete HCV polyprotein also activates PI3K and Akt. We further show that this results in the inhibition of the Akt substrate Forkhead transcription factor and the stimulation of phosphorylation of a second key Akt substrate, glycogen synthase kinase-3 (GSK-3). Phosphorylation of GSK-3 results in its inactivation; consistent with this, we show that expression of the HCV polyprotein results in the accumulation of -catenin. Finally, we show that levels of -catenin-dependent transcription are also elevated in the presence of the HCV polyprotein. Given the prevalence of -catenin mutations in many human tumors, especially colon and hepatocellular carcinomas, these data implicate NS5A-mediated PI3K activation as a contributory factor in the increasingly common association between HCV infection and the development of hepatocellular carcinoma.Hepatitis C virus (HCV) is recognized as a major public health problem; the World Health Organization estimates that as many as 170 million individuals (approximately 3% of the world population) are infected with this virus. In 85% of cases, the virus establishes a chronic infection, culminating in chronic inflammation, cirrhosis, and, increasingly, hepatocellular carcinoma (HCC). Indeed, HCV is now the leading cause of HCC and is the most common reason for liver transplantation in the West (47). Treatment is presently limited to the use of type 1 interferon in combination with the nucleoside analogue ribavirin; this therapeutic regime is successful in 40 to 80% of patients, depending on virus genotype.The HCV genome is a single-stranded positive-sense 9.6-kb RNA molecule, comprising a single open reading frame coding for a polyprotein of ϳ3,000 amino acids flanked by untranslated regions (UTRs). The 5Ј UTR contains an internal ribosome entry sequence, allowing cap-independent initiation of translation. The polyprotein is cleaved into 10 polypeptides by cellular and viral proteinases; one of these products is the nonstructural NS5A protein. NS5A has been the focus of much intensive investigation recently with regard to its potential role both in the cytopathology of HCV infection and in mediating viral immune evasion (for a review, see reference 33). NS5A has been reported to interact with a wide range of cellular proteins involved in, among others, the interferon response and cell cycle control. These interactions result in the modulation of various transcription factors, including NF-B (40, 46), STAT3 (31, 43), and AP-1 (32); furthermore, NS5A has been reported to promote anchorage-i...