{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:11:50Z","timestamp":1788520310596,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Hepatitis C virus (HCV) is a key driver of hepatocellular carcinoma (HCC). However, the impact of HCV eradication on systemic therapy remains unclear. We aimed to assess the safety and efficacy of direct\u2010acting antivirals (DAA) in patients treated with Atezolizumab plus Bevacizumab (AtezoBev).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective multicentre study included patients with HCV\u2010related unresectable\/advanced HCC treated with AtezoBev between 2021 and 2024. Three groups of patients were compared: Group A (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200922), concurrent DAA with AtezoBev; Group B (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200995), antiviral therapy before AtezoBev; and Group C (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200922), active infection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Group A showed the longest median overall survival (42.8\u2009months) compared to Group B (26.8\u2009months;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03) and Group C (19.7\u2009months;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). Time to progression and progression\u2010free survival were significantly prolonged in Group A versus Groups B and C. Moreover, Group A exhibited a higher disease control rate than the other groups. Post\u2010DAA decompensation rates were significantly lower in Group A (4.5%) compared to Groups B (26.3%) and C (36.4%). Treatment\u2010related adverse events of grade \u2265\u20093 were similar across groups. In the multivariate competing risk analysis with adjustment for time\u2010dependent variables, achieving sustained virologic response during AtezoBev showed a protective effect against liver decompensation (sHR 0.02,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) or tumour progression (sHR 0.14,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009), and was also associated with reduced mortality (HR 0.29,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Achieving a SVR during AtezoBev seems to improve oncologic outcomes and reduce liver decompensation in patients with unresectable\/advanced HCC. An integrated therapeutic approach can optimise systemic treatment efficacy, particularly in patients eligible for conversion strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>Protocol ID: 5890<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70362","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T12:16:03Z","timestamp":1758543363000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Hepatitis C Eradication Improves Oncologic and Clinical Outcomes in Patients Treated With Atezolizumab Plus Bevacizumab"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3431-0803","authenticated-orcid":false,"given":"Leonardo","family":"Stella","sequence":"first","affiliation":[{"name":"Liver Unit, CEMAD Centro Malattie del'Apparato Digerente, Medicina Interna e Gastroenterologia Fondazione Policlinico Universitario Gemelli IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Cabibbo","sequence":"additional","affiliation":[{"name":"Policlinico Universitario \u00abPaolo Giaccone\u00bb, Azienda Ospedaliera Universitaria  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciro","family":"Celsa","sequence":"additional","affiliation":[{"name":"Policlinico Universitario \u00abPaolo Giaccone\u00bb, Azienda Ospedaliera Universitaria  Palermo Italy"},{"name":"Department of Surgery and Cancer Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Ciccia","sequence":"additional","affiliation":[{"name":"Policlinico Universitario \u00abPaolo Giaccone\u00bb, Azienda Ospedaliera Universitaria  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alba","family":"Sparacino","sequence":"additional","affiliation":[{"name":"Policlinico Universitario \u00abPaolo Giaccone\u00bb, Azienda Ospedaliera Universitaria  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Piscaglia","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Tovoli","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Arleo","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3800-5678","authenticated-orcid":false,"given":"Bernardo","family":"Stefanini","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Iavarone","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Department Fondazione IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico  Milan Italy"},{"name":"CRC \u201cA. M. and A. Migliavacca\u201d Center for Liver Disease, Department of Pathophysiology and Transplantation University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"D'Ambrosio","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Department Fondazione IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Cerrito","sequence":"additional","affiliation":[{"name":"Liver Unit, CEMAD Centro Malattie del'Apparato Digerente, Medicina Interna e Gastroenterologia Fondazione Policlinico Universitario Gemelli IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Pallozzi","sequence":"additional","affiliation":[{"name":"Liver Unit, CEMAD Centro Malattie del'Apparato Digerente, Medicina Interna e Gastroenterologia Fondazione Policlinico Universitario Gemelli IRCCS  Rome 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