Abstract MicroRNAs (miRNAs) are short non-coding RNAs (ncRNAs) of ~22 nucleotides that mediate gene expression through various functions, including gene silencing, which can lead to translation repression and degradation of target mRNAs. Dysregulation of miRNA function has been associated with numerous diseases, particularly cancer, including hepatocellular carcinoma (HCC). During the progression of HCV-HCC, the function of miRNAs may be altered thereby altering gene expression to favor HCC. Therefore, the involved miRNA-mRNA interaction needs to be further studied. In addition, there are many clinical studies have shown that HCV patients who do not adequately control their diet which are prone to fatty liver accumulation (steatosis), it may increase the possibility of liver cirrhosis. In the current study, we aim to investigate the function and effects of persistent HCV-induced miRNAs expression in liver hepatocellular carcinoma progression and gene expression and to explore the mechanisms and regulatory genes of liver steatosis caused by HCV patients in a high-fat environment. We used the Huh751 cell line and the infected with the HCV JFH1 replicon of low-viral load S2 cells. We used an HCV miRNA array for initial identification of potential candidates. These miRNAs were analyzed for KEGG pathways via DIANA. Next, we identified miRNA-mRNA targets in 3 databases (miRDB; miRPathDB; TargetScan) and analyzed the targets for KEGG pathways using ShinyGO. The target miRNA-mRNA candidate genes were then compared with long-term JFH1 replicon infectious cell (L-HCV) NGS mRNA data to integrate miRNA-mRNA. The identified genes were analyzed in The Cancer Genome Atlas (TCGA) for survival, biological process, and expression in LIHC Big Data. Hsa-miR-215, hsa-mir-10b, and hsa-let-7a of L-HCV miRNAs group showed high significance for LIHC overall survival with a hazard ratio >1.0. Moreover, miRNAs associated with L-HCV survival were LIHC-specific but not in other cancers. Through systematic integration of these findings, we identified HMOX1 and BMF genes as being specifically associated with HCC and regulated by hsa-miR-215-5p, hsa-miR-10b-5p, and hsa-miR-7a-5p. In addition, we also found that the expression of the adipogenesis genes, FABP4 and adipogenesis gene, SREBP1, as well as the viral non-structural protein, NS3, was significantly increased in the HCV-high-fat group; and the expression of the gene IRS1, which is involved in hyperinsulinemia, showed a decreasing trend. The main cause of HCC is that HCV inhibits the expression of hsa-miR-215-5p, hsa-miR-10b-5p, and hsa-miR-7a-5p, leading to alter the expression of target genes, these have a significant effect on survival, suggesting that an essential role in virus-related liver cancer. In the future, we will further explore the regulatory mechanisms between these genes and HCV in a high-fat environment. Citation Format: Wen-Hsiu (Vivian) Su, Ciniso Sylvester Shabangu, Shu-Chi Wang. Integration of microRNAs and transcriptome signatures identifies the persistent infection of hepatitis C virus-induced hepatocellular carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3402.