{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:02:18Z","timestamp":1792839738059,"version":"4.5.0"},"reference-count":99,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Approximately 95% of patients with chronic hepatitis C achieve viral eradication through direct-acting antiviral (DAA) treatment. Ensuing clinical benefits include halting liver fibrosis, thereby reducing the need for liver transplantation, and decreasing both liver-related and overall mortality. It is well established that, although ameliorated, the risk of developing hepatocellular carcinoma (HCC) persists, particularly among patients with pre-treatment advanced fibrosis\/cirrhosis. Current guidelines recommend indefinite HCC surveillance in these patients. However, a recent Markov model evaluation shows that HCC surveillance is cost-effective only for patients with cirrhosis but not so for those with F3 fibrosis, a finding which points out the need to better define the risk of HCC in hepatitis C patients after cure and further characterize pre- and post-treatment factors that might affect the incidence of HCC in this setting. We reviewed the literature analyzing this aspect. Here we summarize the main findings: male gender and older age are independent predictors of increased risk of post-cure HCC development. Moreover, non-invasive tests for hepatic fibrosis, namely FIB4, APRI, and liver stiffness, measured before and after treatment and their post-therapy change, contribute to better stratifying the risk of HCC occurrence. Furthermore, low serum albumin, as well as an AFP above 7 ng\/mL prior to and after DAA therapy, also constitute independent predictors of HCC development. Considering these findings, we propose to classify patients with HCV viral eradication and advanced fibrosis\/cirrhosis into groups of low, medium, or high risk of HCC and to adopt adequate surveillance strategies for each group, including protocols for abbreviated magnetic resonance imaging (MRI) for those at the highest risk.<\/jats:p>","DOI":"10.3390\/cancers17061018","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T07:20:00Z","timestamp":1742282400000},"page":"1018","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Hepatocellular Carcinoma After HCV Eradication with Direct-Acting Antivirals: A Reappraisal Based on New Parameters to Assess the Persistence of Risk"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9092-464X","authenticated-orcid":false,"given":"Eduardo","family":"Fassio","sequence":"first","affiliation":[{"name":"Liver Section, Gastroenterology Service, Hospital Nacional Profesor Alejandro Posadas, El Palomar, Buenos Aires 1684, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7859-6842","authenticated-orcid":false,"given":"Luis","family":"Colombato","sequence":"additional","affiliation":[{"name":"Hospital Brit\u00e1nico de Buenos Aires, Buenos Aires 1280, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gisela","family":"Gualano","sequence":"additional","affiliation":[{"name":"Hospital Regional Dr. Ram\u00f3n Carrillo, Santiago del Estero 4200, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soledad","family":"Perez","sequence":"additional","affiliation":[{"name":"Liver Section, Gastroenterology Service, Hospital Nacional Profesor Alejandro Posadas, El Palomar, Buenos Aires 1684, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8853-0847","authenticated-orcid":false,"given":"Miguel","family":"Puga-Tejada","sequence":"additional","affiliation":[{"name":"Instituto Ecuatoriano de Enfermedades Digestivas, Guayaquil 090505, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0015-1397","authenticated-orcid":false,"given":"Graciela","family":"Landeira","sequence":"additional","affiliation":[{"name":"Liver Section, Gastroenterology Service, Hospital Nacional Profesor Alejandro Posadas, El Palomar, Buenos Aires 1684, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/j.cgh.2016.11.034","article-title":"Hepatocellular carcinoma is the most common indication for liver transplantation and placement on the waitlist in the United States","volume":"15","author":"Yang","year":"2017","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.jhep.2011.05.026","article-title":"The changing scenario of hepatocellular carcinoma over the last two decades in Italy","volume":"56","author":"Santi","year":"2012","journal-title":"J. Hepatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/j.cgh.2014.08.013","article-title":"Temporal trends of nonalcoholic fatty liver disease\u2013related hepatocellular carcinoma in the Veteran Affairs population","volume":"13","author":"Mittal","year":"2015","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/S1665-2681(19)31681-3","article-title":"Etiology of hepatocellular carcinoma in Latin America: A prospective, multicenter, international study","volume":"9","author":"Fassio","year":"2010","journal-title":"Ann. Hepatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1590\/S1807-59322010001200010","article-title":"Clinical and epidemiological aspects of hepatocellular carcinoma in Brazil","volume":"65","author":"Carrilho","year":"2010","journal-title":"Clinics"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1016\/S1473-3099(17)30496-6","article-title":"Glecaprevir plus pibrentasvir for chronic hepatitis C virus genotype 1, 2, 4, 5, or 6 infection in adults with compensated cirrhosis (EXPEDITION-1): A single-arm, open-label, multicentre phase 3 trial","volume":"17","author":"Forns","year":"2017","journal-title":"Lancet Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2599","DOI":"10.1056\/NEJMoa1512610","article-title":"Sofosbuvir and velpatasvir for HCV genotype 1, 2, 4, 5, and 6 infection","volume":"373","author":"Feld","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1056\/NEJMoa1402454","article-title":"Ledipasvir and sofosbuvir for untreated HCV genotype 1 infection","volume":"370","author":"Afdhal","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.7326\/M15-0785","article-title":"Grazoprevir\u2013elbasvir combination therapy for treatment-na\u00efve cirrhotic and noncirrhotic patients with chronic hepatitis C virus genotype 1, 4, or 6 infection. A randomized trial","volume":"163","author":"Zeuzem","year":"2015","journal-title":"Ann. Intern. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1053\/j.gastro.2016.05.049","article-title":"Effectiveness of sofosbuvir, ledipasvir\/sofosbuvir, or paritaprevir\/ritonavir\/ombitasvir and dasabuvir regimens for treatment of patients with hepatitis C in the Veterans Affairs National Health Care System","volume":"151","author":"Ioannou","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1016\/j.jhep.2017.01.028","article-title":"Effectiveness, safety and clinical outcomes of direct-acting antiviral therapy in HCV genotype 1 infection: Results from a Spanish real-world cohort","volume":"66","author":"Calleja","year":"2017","journal-title":"J. Hepatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1177\/2050640617716607","article-title":"Treatment of hepatitis C genotype 1 infection in Germany: Effectiveness and safety of antiviral treatment in a real-world setting","volume":"6","author":"Buggisch","year":"2018","journal-title":"United Eur. Gastroenterol. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1053\/j.gastro.2015.05.010","article-title":"Ledipasvir and sofosbuvir plus ribavirin for treatment of HCV infection in patients with advanced liver disease","volume":"149","author":"Charlton","year":"2015","journal-title":"Gastroenterology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2618","DOI":"10.1056\/NEJMoa1512614","article-title":"Sofosbuvir and velpatasvir for HCV in patients with decompensated cirrhosis","volume":"373","author":"Curry","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1016\/j.jhep.2018.06.010","article-title":"Impact of DAAs on liver transplantation: Major effects on the evolution of indications and results. An ELITA study based on the ELTR registry","volume":"69","author":"Belli","year":"2018","journal-title":"J. Hepatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1002\/hep.29408","article-title":"Impact of sustained virologic response with direct-acting antiviral treatment on mortality in patients with advanced liver disease","volume":"69","author":"Backus","year":"2019","journal-title":"Hepatology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1002\/hep.29811","article-title":"Direct-acting antiviral sustained virologic response: Impact on mortality in patients without advanced liver disease","volume":"68","author":"Backus","year":"2018","journal-title":"Hepatology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"329","DOI":"10.7326\/0003-4819-158-5-201303050-00005","article-title":"Eradication of hepatitis C virus infection and the development of hepatocellular carcinoma. A meta-analysis of observational studies","volume":"158","author":"Morgan","year":"2013","journal-title":"Ann. Intern. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.jhep.2017.08.030","article-title":"HCV eradication induced by direct-acting antiviral agents reduces the risk of hepatocellular carcinoma","volume":"68","author":"Ioannou","year":"2018","journal-title":"J. Hepatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1053\/j.gastro.2017.06.012","article-title":"Risk of hepatocellular cancer in HCV patients treated with direct-acting antiviral agents","volume":"153","author":"Kanwal","year":"2017","journal-title":"Gastroenterology"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Hayes, C.N., Zhang, P., Zhang, Y., and Chayama, K. (2018). Molecular mechanisms of hepatocarcinogenesis following sustained virological response in patients with chronic hepatitis C virus infection. Viruses, 10.","DOI":"10.3390\/v10100531"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2313","DOI":"10.1053\/j.gastro.2019.02.038","article-title":"HCV-induced epigenetic changes associated with liver cancer risk persist after sustained virologic response","volume":"156","author":"Hamdane","year":"2019","journal-title":"Gastroenterology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1111\/jgh.14008","article-title":"Long-term liver stiffness assessment in hepatitis C virus patients undergoing antiviral therapy: Results from a 5-year cohort study","volume":"33","author":"Facciorusso","year":"2018","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e2021173","DOI":"10.1001\/jamanetworkopen.2020.21173","article-title":"Assessment of incidence of and surveillance burden for hepatocellular carcinoma among patients with hepatitis C in the era of direct-acting antiviral agents","volume":"3","author":"Chen","year":"2020","journal-title":"JAMA Netw. Open"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1922","DOI":"10.1097\/HEP.0000000000000466","article-title":"AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma","volume":"78","author":"Singal","year":"2023","journal-title":"Hepatology"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver (2018). EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. J. Hepatol., 69, 182\u2013236. Erratum in J. Hepatol. 2019, 70, 17.","DOI":"10.1016\/j.jhep.2019.01.020"},{"key":"ref_27","unstructured":"European Association for the Study of the Liver (2025). EASL Clinical Practice Guidelines on the management of hepatocellular carcinoma. J. Hepatol., 82, 315\u2013374."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1840","DOI":"10.1016\/j.cgh.2018.12.018","article-title":"Cost effectiveness of hepatocellular carcinoma surveillance after a sustained virologic response to therapy in patients with hepatitis C virus infection and advanced fibrosis","volume":"17","author":"Zangneh","year":"2019","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1093\/cid\/ciaa646","article-title":"The Enhanced Liver Fibrosis Index Predicts Hepatic Fibrosis Superior to FIB4 and APRI in HIV\/HCV Infected Patients","volume":"73","author":"Rouster","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1097\/QAD.0000000000000975","article-title":"Enhanced Liver Fibrosis marker as a non-invasive predictor of mortality in HIV\/HCV-coinfected women from the Women\u2019s Interagency HIV Study","volume":"30","author":"Peters","year":"2016","journal-title":"AIDS"},{"key":"ref_31","unstructured":"(2025, March 15). Guidelines for the Screening, Care and Treatment of Persons with Chronic Hepatitis C Infection. Available online: https:\/\/iris.who.int\/bitstream\/handle\/10665\/205035\/9789241549615_eng.pdf?sequence=1."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1053\/jhep.2003.50346","article-title":"A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C","volume":"38","author":"Wai","year":"2003","journal-title":"Hepatology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1002\/hep.21178","article-title":"Development of a simple noninvasive index to predict significant fibrosis in patients with HIV\/HCV coinfection","volume":"43","author":"Sterling","year":"2006","journal-title":"Hepatology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1053\/j.gastro.2019.07.033","article-title":"Increased risk for hepatocellular carcinoma persists up to 10 years after HCV eradication in patients with baseline cirrhosis or high FIB-4 scores","volume":"157","author":"Ioannou","year":"2019","journal-title":"Gastroenterology"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver, and Asociaci\u00f3n Latinoamericana para el Estudio del H\u00edgado (2015). EASL-ALEH Clinical Practice Guidelines: Non-invasive tests for evaluation of liver disease severity and prognosis. J. Hepatol., 63, 237\u2013264.","DOI":"10.1016\/j.jhep.2015.04.006"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1016\/j.jhep.2018.07.024","article-title":"Development of models estimating the risk of hepatocellular carcinoma after antiviral treatment for hepatitis C","volume":"69","author":"Ioannou","year":"2018","journal-title":"J. Hepatol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1002\/hep.30823","article-title":"Long-term risk of hepatocellular carcinoma in HCV patients treated with direct acting antiviral agents","volume":"71","author":"Kanwal","year":"2020","journal-title":"Hepatology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/j.jhep.2016.06.015","article-title":"Early occurrence and recurrence of hepatocellular carcinoma in HCV-related cirrhosis treated with direct-acting antivirals","volume":"65","author":"Conti","year":"2016","journal-title":"J. Hepatol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1053\/j.gastro.2018.04.008","article-title":"Incidence of hepatocellular carcinoma in patients with HCV-associated cirrhosis treated with direct-acting antiviral agents","volume":"155","author":"Calvaruso","year":"2018","journal-title":"Gastroenterology"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.jhep.2018.03.009","article-title":"Newly diagnosed hepatocellular carcinoma in patients with advanced hepatitis C treated with DAAs: A prospective population study","volume":"69","author":"Romano","year":"2018","journal-title":"J. Hepatol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.dld.2018.10.014","article-title":"Predictors of hepatocellular carcinoma in HCV cirrhotic patients treated with direct acting antivirals","volume":"51","author":"Lleo","year":"2019","journal-title":"Dig. Liver Dis."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1016\/j.cgh.2018.10.038","article-title":"Factors associated with increased risk of de novo or recurrent hepatocellular carcinoma in patients with cirrhosis treated with direct-acting antivirals for HCV infection","volume":"17","author":"Degasperi","year":"2019","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1111\/hepr.13278","article-title":"Predictors of hepatocellular carcinoma occurrence after direct-acting antiviral therapy in patients with HCV infection","volume":"49","author":"Watanabe","year":"2019","journal-title":"Hepatol. Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1007\/s12072-020-10034-0","article-title":"Advanced liver disease outcomes after hepatitis C eradication by human immunodeficiency virus infection in PITER cohort","volume":"14","author":"Quaranta","year":"2020","journal-title":"Hepatol. Int."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1924","DOI":"10.1002\/hep.31588","article-title":"A model based on noninvasive markers predicts very low hepatocellular carcinoma risk after viral response in hepatitis C virus\u2013advanced fibrosis","volume":"72","author":"Manzano","year":"2020","journal-title":"Hepatology"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Ogawa, E., Nomura, H., Nakamuta, M., Furusyo, N., Kajiwara, E., Dohmen, K., Kawano, A., Ooho, A., Azuma, K., and Takahashi, K. (2020). Incidence of hepatocellular carcinoma after treatment with sofosbuvir-based or sofosbuvir-free regimens in patients with chronic hepatitis C. Cancers, 12.","DOI":"10.3390\/cancers12092602"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1111\/apt.15976","article-title":"Association between steatohepatitis biomarkers and hepatocellular carcinoma after hepatitis C elimination","volume":"52","author":"Ogawa","year":"2020","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1016\/j.jhep.2019.10.005","article-title":"Non-invasive prediction of liver related events in HCV compensated advanced chronic liver disease patients after oral antivirals","volume":"72","author":"Pons","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/j.jhep.2020.03.035","article-title":"Hepatocellular carcinoma surveillance after hepatitis C virus eradication: Is liver stiffness measurement more useful than laboratory fibrosis markers?","volume":"73","author":"Nabatchikova","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1002\/jgh3.12007","article-title":"Liver stiffness measurement predicts hepatocellular carcinoma development in patients treated with direct-acting antivirals","volume":"1","author":"Tachi","year":"2017","journal-title":"JGH Open"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1111\/jvh.13103","article-title":"Risk assessment of hepatocellular carcinoma development by magnetic resonance elastography in chronic hepatitis C patients who achieved sustained virological responses by direct-acting antivirals","volume":"26","author":"Tamaki","year":"2019","journal-title":"J. Viral Hepat."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"3013","DOI":"10.1007\/s10620-019-05604-8","article-title":"Role of Liver Stiffness Measurement in Predicting HCC Occurrence in Direct-Acting Antivirals Setting: A Real-Life Experience","volume":"64","author":"Rinaldi","year":"2019","journal-title":"Dig. Dis. Sci."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.dld.2018.02.010","article-title":"Hepatocellular carcinoma risk assessment by the measurement of liver stiffness variations in HCV cirrhotics treated with direct acting antivirals","volume":"50","author":"Ravaioli","year":"2018","journal-title":"Dig. Liver Dis."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1111\/jvh.13167","article-title":"Liver steatosis is a major predictor of poor outcomes in chronic hepatitis C patients with sustained virological response","volume":"26","author":"Peleg","year":"2019","journal-title":"J. Viral Hepat."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/S0168-8278(18)30246-0","article-title":"Post-treatment liver stiffness measurement is not useful to predict hepatocellular carcinoma in HCV patients who achieve SVR","volume":"68","author":"Shili","year":"2018","journal-title":"J. Hepatol."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Morisco, F., Federico, A., Marignani, M., Cannav\u00f2, M., Pontillo, G., Guarino, M., Dallio, M., Begini, P., Benigno, R.G., and Lombardo, F.L. (2021). Risk Factors for Liver Decompensation and HCC in HCV-Cirrhotic Patients after DAAs: A Multicenter Prospective Study. Cancers, 13.","DOI":"10.3390\/cancers13153810"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1111\/hepr.14094","article-title":"High serum gamma-glutamyltransferase level after hepatitis C virus elimination is a risk factor for the development of hepatocellular carcinoma","volume":"54","author":"Murakawa","year":"2024","journal-title":"Hepatol. Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2488","DOI":"10.1002\/hep4.2015","article-title":"Elevated liver enzymes predict morbidity and mortality despite antiviral cure in patients with chronic hepatitis C: Data from the German Hepatitis C-Registry","volume":"6","author":"Tacke","year":"2022","journal-title":"Hepatol. Commun."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Abe, K., Wakabayashi, H., Nakayama, H., Suzuki, T., Kuroda, M., Yoshida, N., Tojo, J., Kogure, A., Rai, T., and Saito, H. (2020). Factors associated with hepatocellular carcinoma occurrence after HCV eradication in patients without cirrhosis or with compensated cirrhosis. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0243473"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1159\/000470910","article-title":"Outcome of All-Oral Direct-Acting Antiviral Regimens on the Rate of Development of Hepatocellular Carcinoma in Patients with Hepatitis C Virus Genotype 1-Related Chronic Liver Disease","volume":"93","author":"Ogata","year":"2017","journal-title":"Oncology"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.2147\/JHC.S389874","article-title":"Repeated Measurement of FIB-4 to Predict Long-Term Risk of HCC Development Up to 10 Years After SVR","volume":"9","author":"Zou","year":"2022","journal-title":"J. Hepatocell. Carcinoma"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1016\/j.dld.2018.09.016","article-title":"Immune inflammation indicators and ALBI score to predict liver cancer in HCV-patients treated with direct-acting antivirals","volume":"51","author":"Gardini","year":"2019","journal-title":"Dig. Liver Dis."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1016\/j.jhep.2021.11.023","article-title":"Liver cancer risk after HCV cure in patients with advanced liver disease without non-characterized nodules","volume":"76","author":"Lens","year":"2022","journal-title":"J. Hepatol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.14309\/ajg.0000000000001968","article-title":"Longitudinal associations of risk factors and hepatocellular cancer in patients with cured hepatitis C virus infection","volume":"117","author":"Kramer","year":"2022","journal-title":"Am. J. Gastroenterol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"138","DOI":"10.14309\/ajg.0000000000001503","article-title":"A 2-Step Strategy Combining FIB-4 With Transient Elastography and Ultrasound Predicted Liver Cancer After HCV Cure","volume":"117","author":"Ampuero","year":"2022","journal-title":"Am. J. Gastroenterol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1016\/j.jhep.2017.05.028","article-title":"Effect of interferon based and -free therapy on early occurrence and recurrence of hepatocellular carcinoma in chronic hepatitis C","volume":"67","author":"Nagata","year":"2017","journal-title":"J. Hepatol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1002\/hep4.1833","article-title":"Hepatocellular Carcinoma Risk Assessment for Patients With Advanced Fibrosis After Eradication of Hepatitis C Virus","volume":"6","author":"Tamaki","year":"2022","journal-title":"Hepatol. Commun."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"2828","DOI":"10.1111\/liv.14666","article-title":"GES: A validated simple score to predict the risk of HCC in patients with HCV-GT4-associated advanced liver fibrosis after oral antivirals","volume":"40","author":"Shiha","year":"2020","journal-title":"Liver Int."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/apt.17802","article-title":"Hepatocellular carcinoma risk decreases as time accrues following hepatitis C virus eradication","volume":"59","author":"Vutien","year":"2024","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1954","DOI":"10.1002\/hep.22870","article-title":"Prospective risk assessment for hepatocellular carcinoma development in patients with chronic hepatitis C by transient elastography","volume":"49","author":"Masuzaki","year":"2009","journal-title":"Hepatology"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1111\/liv.12118","article-title":"Liver stiffness measurement as an alternative to fibrotic stage in risk assessment of hepatocellular carcinoma incidence for chronic hepatitis C patients","volume":"33","author":"Wang","year":"2013","journal-title":"Liver Int."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1016\/j.cgh.2013.07.034","article-title":"Liver stiffness is associated with risk of decompensation, liver cancer, and death in patients with chronic liver diseases: A systematic review and meta-analysis","volume":"11","author":"Singh","year":"2013","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1111\/jgh.15243","article-title":"Impact of liver-stiffness measurement on hepatocellular carcinoma development in chronic hepatitis C patients treated with direct-acting antivirals: A systematic review and time-to-event meta-analysis","volume":"36","author":"You","year":"2021","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"2885","DOI":"10.1111\/liv.15032","article-title":"Hepatocellular carcinoma risk in hepatitis C stage-3 fibrosis after sustained virological response with direct-acting antivirals","volume":"41","author":"Mancebo","year":"2021","journal-title":"Liver Int."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1016\/j.jhep.2020.07.025","article-title":"aMAP risk score predicts hepatocellular carcinoma development in patients with chronic hepatitis","volume":"73","author":"Fan","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1111\/liv.13194","article-title":"Chronic hepatitis C virus infection and the risk for diabetes: A community-based prospective study","volume":"37","author":"Lin","year":"2017","journal-title":"Liver Int."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1093\/aje\/kwm061","article-title":"Hepatitis C Virus Infection and the Development of Type 2 Diabetes in a Community-based Longitudinal Study","volume":"166","author":"Wang","year":"2007","journal-title":"Am. J. Epidemiol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1002\/hep.22703","article-title":"Sustained Virological Response Reduces Incidence of Onset of Type 2 Diabetes in Chronic Hepatitis C","volume":"49","author":"Arase","year":"2009","journal-title":"Hepatology"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1016\/j.cgh.2024.03.006","article-title":"The Global Epidemiology of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis Among Patients with Type 2 Diabetes","volume":"22","author":"Younossi","year":"2024","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/S2468-1253(19)30383-8","article-title":"FibroScan-AST (FAST) score for the non-invasive identification of patients with non-alcoholic steatohepatitis with significant activity and fibrosis: A prospective derivation and global validation study","volume":"5","author":"Newsome","year":"2020","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"100090","DOI":"10.1016\/j.metop.2021.100090","article-title":"Non-alcoholic fatty liver disease is a risk factor for occurrence of hepatocellular carcinoma after sustained virologic response in chronic hepatitis C patients: A prospective four-years follow-up study","volume":"10","author":"Ji","year":"2021","journal-title":"Metabol. Open"},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Liu, C.H., Cheng, P.N., Fang, Y.J., Liu, C.J., Chen, P.J., Kao, J.H., Yang, S.S., Shih, Y.L., Peng, C.Y., and Chang, Y.P. (J. Hepatol., 2024). Risk of de novo HCC in patients with MASLD following direct-acting antiviral-induced cure of HCV infection, J. Hepatol., Online ahead of print.","DOI":"10.1016\/j.jhep.2024.09.038"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1111\/apt.15331","article-title":"Long-term metformin use may improve clinical outcomes in diabetic patients with non-alcoholic steatohepatitis and bridging fibrosis or compensated cirrhosis","volume":"50","author":"Vuppalanchi","year":"2019","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_84","unstructured":"Newsome, P., Sanyal, A., Kliers, I., \u00d8stergaard, L., Long, M., Kj\u00e6r, M., Cali, A.M.G., Bugianesi, E., Rinella, M., and Roden, M. (2024, November 20). Phase 3 ESSENCE Trial: Semaglutide in Metabolic Dysfunction-Associated Steatohepatitis (MASH). AASLD Annual Meeting 2024, Late-Breaking Abstract Supplement 5018. Available online: https:\/\/www.aasld.org\/sites\/default\/files\/2024-11\/TLM2024LBA_20241115A.pdf."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1053\/j.gastro.2024.04.029","article-title":"Association of GLP-1 Receptor Agonists and Hepatocellular Carcinoma Incidence and Hepatic Decompensation in Patients With Type 2 Diabetes","volume":"167","author":"Wang","year":"2024","journal-title":"Gastroenterology"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"e2421305","DOI":"10.1001\/jamanetworkopen.2024.21305","article-title":"Glucagon-Like Peptide 1 Receptor Agonists and 13 Obesity-Associated Cancers in Patients With Type 2 Diabetes","volume":"7","author":"Wang","year":"2024","journal-title":"JAMA Netw. Open"},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Islam, M.M., Poly, T.N., Walther, B.A., Yang, H.C., and Jack Li, Y.C. (2020). Statin Use and the Risk of Hepatocellular Carcinoma: A Meta-Analysis of Observational Studies. Cancers, 12.","DOI":"10.3390\/cancers12030671"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1016\/j.jhep.2021.11.025","article-title":"HCC risk stratification after cure of hepatitis C in patients with compensated advanced chronic liver disease","volume":"76","author":"Semmler","year":"2022","journal-title":"J. Hepatol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1002\/hep.23615","article-title":"Use of surveillance for hepatocellular carcinoma among patients with cirrhosis in the United States","volume":"52","author":"Davila","year":"2010","journal-title":"Hepatology"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1706","DOI":"10.1053\/j.gastro.2018.01.064","article-title":"Surveillance imaging and alpha fetoprotein for early detection of hepatocellular carcinoma in patients with cirrhosis: A meta-analysis","volume":"154","author":"Tzartzeva","year":"2018","journal-title":"Gastroenterology"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1001\/jamaoncol.2016.3147","article-title":"MRI with liver-specific contrast for surveillance of patients with cirrhosis at high risk of hepatocellular carcinoma","volume":"3","author":"Kim","year":"2017","journal-title":"JAMA Oncol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1097\/HEP.0000000000000339","article-title":"Screening of liver cancer with abbreviated MRI","volume":"78","author":"Ronot","year":"2023","journal-title":"Hepatology"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/j.jhep.2019.12.001","article-title":"Non-enhanced magnetic resonance imaging as a surveillance tool for hepatocellular carcinoma: Comparison with ultrasound","volume":"72","author":"Park","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1002\/hep.25681","article-title":"Hepatocellular carcinoma: Detection with diffusion-weighted versus contrast-enhanced magnetic resonance imaging in pretransplant patients","volume":"56","author":"Park","year":"2012","journal-title":"Hepatology"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"527","DOI":"10.2214\/AJR.14.12986","article-title":"Diagnostic per-patient accuracy of an abbreviated hepatobiliary phase gadoxetic acid-enhanced MRI for hepatocellular carcinoma surveillance","volume":"204","author":"Marks","year":"2015","journal-title":"Am. J. Roentgenol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/j.jhep.2024.03.048","article-title":"Comparison of non-contrast abbreviated MRI and ultrasound as surveillance modalities for HCC","volume":"81","author":"Kim","year":"2024","journal-title":"J. Hepatol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"e101","DOI":"10.1038\/ctg.2017.26","article-title":"Cost-effectiveness of risk score\u2013stratified hepatocellular carcinoma screening in patients with cirrhosis","volume":"8","author":"Goossens","year":"2017","journal-title":"Clin. Transl. Gastroenterol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1002\/hep.26739","article-title":"On-treatment alpha-fetoprotein is a specific tumor marker for hepatocellular carcinoma in patients with chronic hepatitis B receiving entecavir","volume":"59","author":"Wong","year":"2014","journal-title":"Hepatology"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1964","DOI":"10.1111\/liv.14197","article-title":"Minimal increases of serum alpha-foetoprotein herald HCC detection in Caucasian HBV cirrhotic patients under long-term oral therapy","volume":"39","author":"Loglio","year":"2019","journal-title":"Liver Int."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/6\/1018\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:55:53Z","timestamp":1760028953000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/6\/1018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,18]]},"references-count":99,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["cancers17061018"],"URL":"https:\/\/doi.org\/10.3390\/cancers17061018","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,18]]}}}