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A pooled estimate was calculated using the DerSimonian and Laird method for a random effects model. The study was conducted in accordance with PRISMA<\/jats:styled-content> guidelines.<\/jats:p><\/jats:sec>Results<\/jats:title>Among 24 studies (n\u00a0=\u00a01820 patients), the proportion of patients with HCC<\/jats:styled-content> recurrence following DAA<\/jats:styled-content> therapy ranged from 0% to 59% (pooled estimate 24.4%; 95% CI<\/jats:styled-content>: 18.4%\u201030.4%). Among 11 full text manuscripts, pooled HCC<\/jats:styled-content> recurrence was 21.9% (95% CI<\/jats:styled-content>: 16.2%\u201028.3%). Factors associated with recurrence included history of prior HCC<\/jats:styled-content> recurrence and a shorter interval between HCC<\/jats:styled-content> complete response and DAA<\/jats:styled-content> initiation. Nine studies comparing DAA<\/jats:styled-content>\u2010treated and interferon\u2010treated or untreated patients found similar recurrence among DAA<\/jats:styled-content>\u2010treated patients. Most (77.8%) patients with HCC<\/jats:styled-content> recurrence were detected at an early tumour stage, of whom 64.7% received curative treatment. Study limitations included heterogeneous cohorts, potential misclassification of HCC<\/jats:styled-content> absence prior to DAA<\/jats:styled-content>, ascertainment bias for recurrence, and short durations of follow\u2010up.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Current data suggest acceptable HCC<\/jats:styled-content> recurrence rates after DAA<\/jats:styled-content> therapy, particularly if DAA<\/jats:styled-content> therapy is delayed at least 6\u00a0months after HCC<\/jats:styled-content> complete response. However, data characterising HCC<\/jats:styled-content> recurrence after DAA<\/jats:styled-content> therapy are of limited quality, highlighting the need for high quality prospective studies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.14823","type":"journal-article","created":{"date-parts":[[2018,5,31]],"date-time":"2018-05-31T06:10:52Z","timestamp":1527747052000},"page":"127-137","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":69,"title":["Systematic review with meta\u2010analysis: recurrence of hepatocellular carcinoma following direct\u2010acting antiviral therapy"],"prefix":"10.1111","volume":"48","author":[{"given":"N.","family":"Saraiya","sequence":"first","affiliation":[{"name":"Department of Internal Medicine UT Southwestern Medical Center Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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