{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T10:51:10Z","timestamp":1775904670276,"version":"3.50.1"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>The risk of developing hepatocellular carcinoma (HCC) persists in patients with cirrhosis and a sustained virologic response (SVR, the eradication of hepatitis C virus [HCV]), and therefore surveillance for HCC is recommended. However, patients with mild or no fibrosis are usually at low risk and HCC surveillance is not recommended in many guidelines. Nevertheless, some patients experience post\u2010SVR HCC despite having low degree liver fibrosis. We characterized the changes in liver fibrosis in patients in whom HCC developed after SVR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>We performed a nationwide multicenter study, during which HCC developed in 332 of 6047 patients (5.5%) with no history of HCC who achieved SVR. FIB\u20104 index, the laboratory index of liver fibrosis, was calculated at the start of anti\u2010HCV therapy and at a diagnosis of HCC, and the changes were characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Most patients who developed HCC after SVR had cirrhosis or advanced liver fibrosis (FIB\u20104 index &gt;\u20093.25) before anti\u2010HCV therapy, including some whose liver fibrosis regressed after SVR. Some patients (3.6%) without substantial fibrosis (FIB\u20104 index \u2264\u20093.25) before anti\u2010HCV therapy developed HCC with the progression of liver fibrosis after SVR. Finally, 5 patients (1.6%) had mild or no fibrosis (FIB\u20104 index &lt;\u20091.45) both before anti\u2010HCV therapy and when HCC developed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Most HCCs in patients who achieve SVR develop in association with liver cirrhosis or advanced fibrosis, but some develop in livers without substantial fibrosis. In addition, post\u2010SVR HCC can develop in patients with mild or no fibrosis both before anti\u2010HCV therapy and after SVR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jmv.70865","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T15:04:08Z","timestamp":1772982248000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Changes in the Liver Fibrosis of Patients Who Develop Hepatocellular Carcinoma After a Sustained Virologic Response to Hepatitis C Virus Infection"],"prefix":"10.1002","volume":"98","author":[{"given":"Hidenori","family":"Toyoda","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Ogaki Municipal Hospital Ogaki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akito","family":"Nozaki","sequence":"additional","affiliation":[{"name":"Gastroenterology Center Yokohama City University Medical Center Yokohama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Hiraoka","sequence":"additional","affiliation":[{"name":"Gastroenterology Center Ehime Prefectural Central Hospital Matsuyama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ei","family":"Itobayashi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Asahi General Hospital Asahi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haruki","family":"Uojima","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Internal Medicine Kitasato University School of Medicine Sagamihara Japan"},{"name":"Department of Gastroenterology and Hepatology, Faculty of Life Sciences Kumamoto University Kumamoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology and Hepatology Shinmatusdo Central General Hospital Matsudo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichi","family":"Takaguchi","sequence":"additional","affiliation":[{"name":"Department of Hepatology Kagawa Prefectural Central Hospital Takamatsu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3374-7111","authenticated-orcid":false,"given":"Masanori","family":"Atsukawa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology and Hepatology Nippon Medical School Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norio","family":"Itokawa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology Nippon Medical School Chiba Hokusoh Hospital Inzai 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School of Medicine Kawasaki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeru","family":"Mikami","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology Kikkoman General Hospital Noda Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunihiko","family":"Tsuji","sequence":"additional","affiliation":[{"name":"Center for Gastroenterology Teine Keijinkai Hospital Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideko","family":"Ohama","sequence":"additional","affiliation":[{"name":"Gastroenterology Center Ehime Prefectural Central Hospital Matsuyama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fujimasa","family":"Tada","sequence":"additional","affiliation":[{"name":"Gastroenterology Center Ehime Prefectural Central Hospital Matsuyama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akemi","family":"Tsutsui","sequence":"additional","affiliation":[{"name":"Department of Hepatology Kagawa Prefectural Central Hospital Takamatsu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomomi","family":"Okubo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology and Hepatology Nippon Medical School Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taeang","family":"Arai","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology and Hepatology Nippon Medical School Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Nakamuta","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology National Hospital Organization Kyushu Medical Center Fukuoka 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