Kanwal F, et al. - Researchers conducted this retrospective cohort study to evaluate the long-term risk of hepatocellular carcinoma (HCC) in HCV patients treated with direct-acting antiviral agents (DAAs). Participants in the study were hepatitis C virus (HCV)-infected patients who achieved sustained virologic response (SVR) with DAAs from 129 Veterans Health Administration hospitals between January 1, 2015, and December 31, 2015, with follow-up through September 30, 2018. Of 18,076 SVR patients, 544 HCC incident cases were diagnosed over a mean 2.9 years of follow-up. According to results, the cumulative 1, 2 and 3-year risks of HCC were 1.1%, 1.9% and 2.8%, respectively. There was a strong association between cirrhosis and HCC risk. In individuals with persistently high FIB-4/APRI and both with and without cirrhosis, the risk of HCC was the highest. Investigators found that most patients treated at an early stage of liver fibrosis had a stable low risk. Patients treated with DAAs and at risk of HCC did not regress following 3.6 years of follow-up. HCC risk in patients with cirrhosis stayed above the accepted thresholds for monitoring. In cured HCV patients, these data have significant implications for HCC monitoring.