{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:48:56Z","timestamp":1773017336784,"version":"3.50.1"},"reference-count":28,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Aims: Glecaprevir\/pibrentasvir achieves sustained virologic response (SVR) rates above 95% in chronic hepatitis C (CHC). Nevertheless, the residual risk of hepatocellular carcinoma (HCC) after SVR, especially in patients with advanced liver disease, has not been fully defined. We prospectively evaluated longitudinal changes in liver function and fibrosis and sought predictors of post-SVR HCC in a real-world multicenter cohort. Methods: A total of 395 CHC patients who attained SVR with glecaprevir\/pibrentasvir were followed prospectively. Liver function tests, noninvasive fibrosis indices, and clinical outcomes were recorded at predefined intervals. Cox proportional hazards regression identified factors associated with incident HCC. Results: Over a median follow-up of 31.1 months, HCC occurred in 16 patients (4.1%). From univariate analysis, baseline FIB-4 &gt; 3.25, APRI &gt; 1.5, MELD \u2265 10, Child\u2013Pugh score \u2265 6, and clinically significant portal hypertension were associated with HCC. Multivariate analysis retained FIB-4 &gt; 3.25 (p = 0.003) and MELD \u2265 10 (p = 0.032) as independent predictors. Cumulative incidence rose stepwise with the number of risk factors. Conclusions: Despite a virologic cure, patients with advanced fibrosis or impaired liver function remain susceptible to HCC. Risk stratification using FIB-4 and MELD and continued surveillance are therefore warranted.<\/jats:p>","DOI":"10.3390\/medicina61091601","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T15:31:21Z","timestamp":1756999881000},"page":"1601","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Longitudinal Effects of Glecaprevir\/Pibrentasvir on Liver Function, Fibrosis, and Hepatocellular Carcinoma Risk in Chronic Hepatitis C: A Prospective Multicenter Cohort Study"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5435-6166","authenticated-orcid":false,"given":"Jung Hee","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Hallym University College of Medicine, Dongtan Sacred Heart Hospital, Hwasung 14068, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4993-2496","authenticated-orcid":false,"given":"Jae Hyun","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Chonnam National University Hospital, College of Medicine, Gwangju 61469, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6236-780X","authenticated-orcid":false,"given":"Sung-Eun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hallym University College of Medicine, Anyang 14068, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5884-9993","authenticated-orcid":false,"given":"Ji-Won","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hallym University College of Medicine, Anyang 14068, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yewan","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul 02447, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gi-Ae","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul 02447, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1767-0233","authenticated-orcid":false,"given":"Seong Kyun","family":"Na","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul 01757, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6396-0859","authenticated-orcid":false,"given":"Young-Sun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Korea University Medical Center, Seoul 08308, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8383-8524","authenticated-orcid":false,"given":"Jeong Han","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Konkuk University School of Medicine, Seoul 05030, Republic of Korea"},{"name":"Research Institute of Medical Science, Konkuk University School of Medicine, Seoul 05029, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2016). 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