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These studies suggest three mechanisms for the production of this protein concerning ribosomal frameshift at codon 10, initial translation at codons 26 and 85 or 87. In this study, the association between protein F and chronicity of hepatocellular carcinoma (HCC) has been reviewed. Evidence suggests that humoral immune system can recognize this protein and produce antibodies against it. By detecting antibodies in infected people, investigators found that F protein might have a role in HCV infection causing chronic cirrhosis and HCC as higher prevalence was found in patients with mentioned complications. The increment of CD4+, CD25+, and FoxP3+ T cells, along with CD8+ T cells with low expression of granzyme B, also leads to weaker responses of the immune system which helps the infection to become chronic. Moreover, it contributes to the survival of the virus in the body through affecting the production of interferon. F protein also might play roles in the disease development, resulting in HCC. The existence of F protein affects cellular pathways through upregulating p53, c\u2010myc, cyclin D1, and phosphorylating Rb. This review will summarize these effects on immune system and related mechanisms in cellular pathways.<\/jats:p>","DOI":"10.1002\/jmv.26091","type":"journal-article","created":{"date-parts":[[2020,5,29]],"date-time":"2020-05-29T17:39:37Z","timestamp":1590773977000},"page":"2930-2937","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Hepatitis C virus alternative reading frame protein (ARFP): Production, features, and pathogenesis"],"prefix":"10.1002","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7958-9211","authenticated-orcid":false,"given":"Mahdi","family":"Mohamadi","sequence":"first","affiliation":[{"name":"Student Research Committee, Faculty of Medicine Lorestan University of Medical Sciences  Khorramabad 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