Hepatitis C virus (HCV) infection is a major cause of non-A, non-B hepatitis, which frequently leads to chronic liver disease and hepatocellular carcinoma (1); no vaccine is available, while the recent broadly effective therapy is highly expensive (2, 3). The single-stranded positive-sense RNA genome of HCV (9.6 kb) encodes a polyprotein precursor of about 3,000 amino acids flanked by conserved untranslated regions (UTRs) (4, 5). The UTRs are required for RNA translation and replication, and an internal ribosome entry site (IRES) within the 5= UTR controls translation initiation (6). The polyprotein is processed by cellular and viral proteases to yield at least 10 structural and nonstructural proteins (C, E1, E2, p7, NS2, NS3, NS4A, NS4B, NS5A, and NS5B) (4, 5).Previous studies from our laboratory and others have shown that HCV possesses a second functional open reading frame (ORF) within the core region of the polyprotein encoding an additional protein designated coreϩ1/alternative reading frame protein (ARFP) (7-9). This alternate ORF is present in all six HCV genotypes (9) but has been studied only in subtypes 1a and 1b. At first, a 17-kDa protein (p17), initially named ARFP (alternative reading frame protein), F (frameshift), or coreϩ1 (to indicate its position), was shown to be synthesized in rabbit reticulocyte lysate (RRL) from the initiating codon of the polyprotein sequence of a genotype 1a HCV type 1 (HCV-1) strain by a ϩ1 frameshift occurring in an A-rich core-encoding region (codons 8 to 11) (7-10). However, the expression of this form of coreϩ1/ARFP (known as F) is limited to the HCV-1 isolate, which is unique in carrying a stretch of 10 consecutive adenine nucleotides within codons 8 to 11 (7,11,12), and its expression in transfected cells is dependent on cytoplasmic transcription (11). Interestingly, other coreϩ1/ARFP forms are expressed independently of the A-rich sequence by an alternative translation mechanism(s). Internal translation initiation at methionine codons 85/87 of HCV-1a and HCV-1b, resulting in a shorter form of coreϩ1/ARFP, has been observed in transfected hepatoma cells (13-15). Furthermore, codon 26 of HCV-1a (12) and HCV-1b (15) was also found to function as an internal translation initiation site in mammalian cells. Additionally, a ϩ1 frameshift at codon 42 of HCV-1b, followed by a rephrasing into the core ORF at stop codon 144, was observed in Escherichia coli (16).The detection of specific anti-coreϩ1/ARFP antibodies and T-cell responses in HCV-infected patients (especially with hepatocellular carcinoma), as reported by many independent laboratories, provides strong evidence that coreϩ1/ARFP is produced during natural infection (7-9, 17-21). These studies suggest a link between coreϩ1/ARFP and development of liver cancer (22-27). Conversely, coreϩ1/ARFP has no obvious effect on virus replication following electroporation of Huh7-Lunet cells with fulllength JFH1 wild-type and mutated viral RNAs or in mice xenografted with human liver tissue (28). Those studies were based on a ...