{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T12:31:44Z","timestamp":1790857904852,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T00:00:00Z","timestamp":1749772800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    The long\u2010term impact of direct\u2010acting antivirals (DAAs) in chronic hepatitis C virus (HCV) patients remains debated. This study evaluates all\u2010cause mortality, hepatocellular carcinoma (HCC), and decompensated cirrhosis in DAAs\u2010treated patients enrolled in the \u2018Educate, Test, and Treat\u2019 programme. This prospective observational study included HCV patients treated at the Egyptian Liver Research Institute and Hospital (ELRIAH) from 2015 to 2018. Participants were recruited from 12 villages and followed until the end of 2024. Exclusions included decompensated liver disease, hepatitis B virus (HBV)\/human immunodeficiency virus (HIV) co\u2010infection, prior HCC, or severe comorbidities. Follow\u2010up included clinical, biochemical, ultrasound, and liver stiffness measurements (LSM). Primary outcomes were all\u2010cause mortality, HCC, and decompensated cirrhosis. Kaplan\u2013Meier curves and Cox models analyse data. Of 3328 eligible patients, follow\u2010up data were available for 3017 (53% male, mean follow\u2010up: 84.5\u2009\u00b1\u200928.9\u2009months). Advanced fibrosis (F3\u2013F4) was present in 1125 (37.3%). The study recorded 593 deaths (2.58\/100 person\u2010years), 271 HCC cases (1.24\/100 person\u2010years), and 281 decompensated cirrhosis cases (1.30\/100 person\u2010years). Advanced fibrosis was associated with increased mortality (HR: 1.72, 95% CI: 1.46\u20132.03,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and decompensation (HR: 2.23, 95% CI: 1.74\u20132.85,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) but not HCC (HR: 1.17, 95% CI: 0.92\u20131.49,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.192). Fibrosis reversed in 11.9%, improved in 17.8%, remained stable in 50.5%, and progressed in 19.8%. This decade\u2010long study confirms DAAs improve liver function, reduce mortality, and slow disease progression, reinforcing their role in preventing long\u2010term complications.\n                  <\/jats:p>","DOI":"10.1111\/jvh.70044","type":"journal-article","created":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T06:24:35Z","timestamp":1749795875000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Long Term Clinical Outcomes in Chronic Hepatitis C Patients Who Achieved\n                    <scp>SVR<\/scp>\n                    Following\n                    <scp>DAA<\/scp>\n                    s: A Decade Long Prospective Study"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9338-8854","authenticated-orcid":false,"given":"Gamal","family":"Shiha","sequence":"first","affiliation":[{"name":"Egyptian Liver Research Institute and Hospital (ELRIAH)  Mansoura Egypt"},{"name":"Gastroenterology and Hepatology Unit, Internal Medicine Department, Faculty of Medicine Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4945-7389","authenticated-orcid":false,"given":"Ahmed","family":"Helmy","sequence":"additional","affiliation":[{"name":"Tropical Medicine and Gastroenterology Department, Faculty of Medicine Assiut University  Assiut Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabiel","family":"Mikhail","sequence":"additional","affiliation":[{"name":"Egyptian Liver Research Institute and Hospital (ELRIAH)  Mansoura Egypt"},{"name":"Biostatistics and Cancer Epidemiology Department, South Egypt Cancer Institute Assiut University  Assiut Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3423-1037","authenticated-orcid":false,"given":"Ayman","family":"Hassan","sequence":"additional","affiliation":[{"name":"Egyptian Liver Research Institute and Hospital (ELRIAH)  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Elkerdawy","sequence":"additional","affiliation":[{"name":"Clinical Hematology Unit, Internal Medicine Department, Faculty of Medicine Port Said University  Port Said Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghada","family":"Badawy","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Unit, Internal Medicine Department, Faculty of Medicine Port Said University  Port Said Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanzada","family":"El Maghrabi","sequence":"additional","affiliation":[{"name":"Nephrology Unit, Internal Medicine Department, Faculty of Medicine Port Said University  Port Said Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7098-0230","authenticated-orcid":false,"given":"Nada","family":"El\u2010Domiaty","sequence":"additional","affiliation":[{"name":"Endemic Medicine Department, Faculty of Medicine Helwan University  Helwan Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4562-9748","authenticated-orcid":false,"given":"Riham","family":"Soliman","sequence":"additional","affiliation":[{"name":"Egyptian Liver Research Institute and Hospital (ELRIAH)  Mansoura Egypt"},{"name":"Tropical Medicine Department, Faculty of Medicine Port Said University  Port Said Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.08.018"},{"issue":"6","key":"e_1_2_8_3_1","article-title":"Direct\u2010Acting Antivirals for Chronic Hepatitis C","volume":"6","author":"Jakobsen J. 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