{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T01:37:58Z","timestamp":1788399478175,"version":"build-2803163510"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["23HC1001"],"award-info":[{"award-number":["23HC1001"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Japan Institute for Health Security"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Gastroenterol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Long-term follow-up is essential after a sustained virologic response (SVR) to direct-acting antivirals (DAAs) in patients with chronic hepatitis C. However, real-world continuity of care and determinants of disengagement are poorly characterized at the national level. Here, we quantified the follow-up continuity within Japan\u2019s government-designated regional core centers and identified independent factors associated with transfer and self-discontinuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective multicenter cohort study of 3702 patients with chronic hepatitis C who achieved SVR at 16 regional core centers (2015\u20132018). Continuation was assessed using Kaplan\u2013Meier analysis and competing-risk analysis, and Fine\u2013Gray regression identified determinants of transfer and discontinuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At 5\u00a0years, 56% of the patients were followed up, 24% were transferred, and 18% self-discontinued. Older age was significantly associated with transfer (subdistribution hazard ratio [sHR] 1.41, 95% CI 1.23\u20131.61), whereas hepatocellular carcinoma (HCC) and other malignancies favored continuous follow-up. Self-discontinuation was more frequent with hepatitis C virus (HCV) serotype 2 (sHR 1.36, 95% CI 1.18\u20131.57) and less common among patients with advanced disease or prior hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Within Japan\u2019s core-center network, long-term continuation after SVR is high but not universal. Follow-up was generally maintained for patients with severe comorbidities, while disengagement was more likely among those with lower perceived risk. Strengthening low-intensity, structured support for such patients may improve the continuity and equity of post-SVR care. These findings provide a foundation for optimizing post-SVR care pathways in national liver disease networks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00535-026-02345-0","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T07:24:07Z","timestamp":1769498647000},"page":"477-486","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Continuity of long-term follow-up in patients with chronic hepatitis C after sustained virologic response following direct-acting antiviral therapy: a nationwide real-world multicenter cohort study in Japan"],"prefix":"10.1007","volume":"61","author":[{"given":"Masatsugu","family":"Ohara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritsuzo","family":"Kozuka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihito","family":"Uchida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chikara","family":"Iino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Sasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Tojima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhito","family":"Kawata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoru","family":"Kakizaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshio","family":"Tokumoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mizuki","family":"Endo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Asai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Nagata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirokazu","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuro","family":"Shimakami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Ogawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaru","family":"Enomoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Ikegami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Ide","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoya","family":"Sakamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6360-8297","authenticated-orcid":false,"given":"Masaaki","family":"Korenaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,27]]},"reference":[{"key":"2345_CR1","doi-asserted-by":"publisher","first-page":"e362","DOI":"10.1016\/s1473-3099(24)00307-4","volume":"24","author":"T Burki","year":"2024","unstructured":"Burki T. WHO\u2019s 2024 global hepatitis report. Lancet Infect Dis. 2024;24:e362\u20133. https:\/\/doi.org\/10.1016\/s1473-3099(24)00307-4.","journal-title":"Lancet Infect Dis"},{"key":"2345_CR2","doi-asserted-by":"publisher","unstructured":"European Association for the Study of the Liver, Clinical Practice Guidelines Panel: Chair, EASL Governing Board representative, Panel members. EASL recommendations on treatment of hepatitis C: Final update of the series. J Hepatol. 2020;73:1170\u2013218. https:\/\/doi.org\/10.1016\/j.jhep.2020.08.018.","DOI":"10.1016\/j.jhep.2020.08.018"},{"key":"2345_CR3","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad319","author":"D Bhattacharya","year":"2023","unstructured":"Bhattacharya D, Aronsohn A, Price J, et al. Hepatitis C Guidance 2023 update: AASLD-IDSA recommendations for testing, managing, and treating hepatitis C virus infection. Clin Infect Dis. 2023. https:\/\/doi.org\/10.1093\/cid\/ciad319.","journal-title":"Clin Infect Dis"},{"key":"2345_CR4","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.1016\/S0140-6736(23)01320-X","volume":"402","author":"M Martinello","year":"2023","unstructured":"Martinello M, Solomon SS, Terrault NA, et al. Hepatitis C. Lancet. 2023;402:1085\u201396. https:\/\/doi.org\/10.1016\/S0140-6736(23)01320-X.","journal-title":"Lancet"},{"key":"2345_CR5","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1016\/s2468-1253(21)00472-6","volume":"7","author":"Polaris Observatory HCV Collaborators","year":"2022","unstructured":"Polaris Observatory HCV Collaborators. Global change in hepatitis C virus prevalence and cascade of care between 2015 and 2020: a modelling study. Lancet Gastroenterol Hepatol. 2022;7:396\u2013415. https:\/\/doi.org\/10.1016\/s2468-1253(21)00472-6.","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2345_CR6","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2022.103588","volume":"102","author":"T Schwarz","year":"2022","unstructured":"Schwarz T, Horvath I, Fenz L, et al. Interventions to increase linkage to care and adherence to treatment for hepatitis C among people who inject drugs: a systematic review and practical considerations from an expert panel consultation. Int J Drug Policy. 2022;102:103588. https:\/\/doi.org\/10.1016\/j.drugpo.2022.103588.","journal-title":"Int J Drug Policy"},{"key":"2345_CR7","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaf056","volume":"12","author":"R Mathews","year":"2025","unstructured":"Mathews R, Shen C, Traeger MW, et al. Enhancing hepatitis C virus testing, linkage to care, and treatment commencement in hospitals: a systematic review and meta-analysis. Open Forum Infect Dis. 2025;12:ofaf056. https:\/\/doi.org\/10.1093\/ofid\/ofaf056.","journal-title":"Open Forum Infect Dis"},{"key":"2345_CR8","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-022-00645-2","author":"WCW Wong","year":"2022","unstructured":"Wong WCW, Marley G, Li J, et al. A randomized controlled trial enhancing viral hepatitis testing in primary care via digital crowdsourced intervention. NPJ Digit Med. 2022. https:\/\/doi.org\/10.1038\/s41746-022-00645-2.","journal-title":"NPJ Digit Med"},{"key":"2345_CR9","doi-asserted-by":"publisher","first-page":"308","DOI":"10.35772\/ghm.2021.01072","volume":"3","author":"M Korenaga","year":"2021","unstructured":"Korenaga M, Kanto T. Testing, diagnosis of viral hepatitis, and the follow-up policy in Japan. Glob Health Med. 2021;3:308\u201313. https:\/\/doi.org\/10.35772\/ghm.2021.01072.","journal-title":"Glob Health Med"},{"key":"2345_CR10","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1016\/j.jhep.2024.04.007","volume":"81","author":"T Reiberger","year":"2024","unstructured":"Reiberger T, Lens S, Cabibbo G, et al. EASL position paper on clinical follow-up after HCV cure. J Hepatol. 2024;81:326\u201344. https:\/\/doi.org\/10.1016\/j.jhep.2024.04.007.","journal-title":"J Hepatol"},{"key":"2345_CR11","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1002\/hep.31060","volume":"71","author":"MG Ghany","year":"2020","unstructured":"Ghany MG, Morgan TR, H C G Panel A-I. Hepatitis C guidance 2019 update: American Association for the Study of Liver Diseases-Infectious Diseases Society of America recommendations for testing, managing, and treating hepatitis C virus infection. Hepatology. 2020;71:686\u2013721. https:\/\/doi.org\/10.1002\/hep.31060.","journal-title":"Hepatology"},{"key":"2345_CR12","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1016\/j.jhep.2020.10.016","volume":"74","author":"GN Ioannou","year":"2021","unstructured":"Ioannou GN. HCC surveillance after SVR in patients with F3\/F4 fibrosis. J Hepatol. 2021;74:458\u201365. https:\/\/doi.org\/10.1016\/j.jhep.2020.10.016.","journal-title":"J Hepatol"},{"key":"2345_CR13","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1007\/s12072-019-09988-7","volume":"13","author":"T Kanda","year":"2019","unstructured":"Kanda T, Lau GKK, Wei L, et al. APASL HCV guidelines of virus-eradicated patients by DAA on how to monitor HCC occurrence and HBV reactivation. Hepatol Int. 2019;13:649\u201361. https:\/\/doi.org\/10.1007\/s12072-019-09988-7.","journal-title":"Hepatol Int"},{"key":"2345_CR14","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1159\/000514174","volume":"10","author":"M Kudo","year":"2021","unstructured":"Kudo M, Kawamura Y, Hasegawa K, et al. Management of hepatocellular carcinoma in Japan: JSH consensus statements and recommendations 2021 update. Liver Cancer. 2021;10:181\u2013223. https:\/\/doi.org\/10.1159\/000514174.","journal-title":"Liver Cancer"},{"key":"2345_CR15","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1097\/meg.0000000000002358","volume":"34","author":"H Toyoda","year":"2022","unstructured":"Toyoda H, Yasuda S, Shiota S, et al. Adherence to regular surveillance visits for hepatocellular carcinoma in patients with chronic hepatitis C virus infection who achieved sustained virologic response. Eur J Gastroenterol Hepatol. 2022;34:693\u20137. https:\/\/doi.org\/10.1097\/meg.0000000000002358.","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"2345_CR16","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1002\/hep4.1833","volume":"6","author":"N Tamaki","year":"2022","unstructured":"Tamaki N, Kurosaki M, Yasui Y, et al. Hepatocellular carcinoma risk assessment for patients with advanced fibrosis after eradication of hepatitis C virus. Hepatol Commun. 2022;6:461\u201372. https:\/\/doi.org\/10.1002\/hep4.1833.","journal-title":"Hepatol Commun"},{"key":"2345_CR17","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1002\/jgh3.12914","volume":"7","author":"S Ishido","year":"2023","unstructured":"Ishido S, Tamaki N, Kurosaki M, et al. Necessity for surveillance for hepatocellualr carcinoma in older patients with chronic hepatitis C who achieved sustained virological response. JGH Open. 2023;7:424\u201330. https:\/\/doi.org\/10.1002\/jgh3.12914.","journal-title":"JGH Open"},{"key":"2345_CR18","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13153694","author":"R Flisiak","year":"2021","unstructured":"Flisiak R, Zarebska-Michaluk D, Janczewska E, et al. Five-year follow-up of cured HCV patients under real-world interferon-free therapy. Cancers (Basel). 2021. https:\/\/doi.org\/10.3390\/cancers13153694.","journal-title":"Cancers (Basel)"},{"key":"2345_CR19","doi-asserted-by":"publisher","first-page":"1832","DOI":"10.1111\/liv.14469","volume":"40","author":"S Aleman","year":"2020","unstructured":"Aleman S, Soderholm J, Busch K, et al. Frequent loss to follow-up after diagnosis of hepatitis C virus infection: a barrier towards the elimination of hepatitis C virus. Liver Int. 2020;40:1832\u201340. https:\/\/doi.org\/10.1111\/liv.14469.","journal-title":"Liver Int"},{"key":"2345_CR20","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1111\/hepr.12897","volume":"47","author":"N Oza","year":"2017","unstructured":"Oza N, Isoda H, Ono T, et al. Current activities and future directions of comprehensive hepatitis control measures in Japan: the supportive role of the Hepatitis Information Center in building a solid foundation. Hepatol Res. 2017;47:487\u201396. https:\/\/doi.org\/10.1111\/hepr.12897.","journal-title":"Hepatol Res"},{"key":"2345_CR21","doi-asserted-by":"publisher","first-page":"1840","DOI":"10.1016\/j.cgh.2018.12.018","volume":"17","author":"H Farhang Zangneh","year":"2019","unstructured":"Farhang Zangneh H, Wong WWL, Sander B, et al. Cost effectiveness of hepatocellular carcinoma surveillance after a sustained virologic response to therapy in patients with hepatitis C virus infection and advanced fibrosis. Clin Gastroenterol Hepatol. 2019;17:1840-1849 e1816. https:\/\/doi.org\/10.1016\/j.cgh.2018.12.018.","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2345_CR22","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.jhep.2022.01.027","volume":"77","author":"PP Mueller","year":"2022","unstructured":"Mueller PP, Chen Q, Ayer T, et al. Duration and cost-effectiveness of hepatocellular carcinoma surveillance in hepatitis C patients after viral eradication. J Hepatol. 2022;77:55\u201362. https:\/\/doi.org\/10.1016\/j.jhep.2022.01.027.","journal-title":"J Hepatol"},{"key":"2345_CR23","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1111\/hepr.13410","volume":"49","author":"A Tamori","year":"2019","unstructured":"Tamori A, Inoue K, Kagawa T, et al. Intention-to-treat assessment of glecaprevir + pibrentasvir combination therapy for patients with chronic hepatitis C in the real world. Hepatol Res. 2019;49:1365\u201373. https:\/\/doi.org\/10.1111\/hepr.13410.","journal-title":"Hepatol Res"}],"container-title":["Journal of Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00535-026-02345-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00535-026-02345-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00535-026-02345-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T15:43:58Z","timestamp":1777131838000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00535-026-02345-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,27]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["2345"],"URL":"https:\/\/doi.org\/10.1007\/s00535-026-02345-0","relation":{},"ISSN":["0944-1174","1435-5922"],"issn-type":[{"value":"0944-1174","type":"print"},{"value":"1435-5922","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,27]]},"assertion":[{"value":"9 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Prof. Tadashi Ikegami received lecture fees from AbbVie GK and Gilead Sciences, Inc. Dr. Jun Inoue received honoraria from Gilead Sciences, Inc. Prof. Hirokazu Takahashi received research grants from Sysmex, Takeda, Kracie, and Miz, and honoraria for lectures from Novo Nordisk, AbbVie, and Lilly. Dr. Satoshi Kakizaki received lecture fees from AbbVie Inc. Prof. Naoya Sakamoto received lecture fees from Chugai Pharmaceutical Co., Ltd. and research grants from Gilead Sciences, Inc. and AbbVie, Inc. The other authors declare no conflicts of interest related to this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}