D’Ambrosio R, Degasperi E, Anolli MP, et al. - Researchers sought to report the long-term benefits of a sustained virological response (SVR) in hepatitis C virus (HCV) cirrhosis following direct-acting antivirals (DAA).

• A longitudinal, single-center study of consecutive DAA-treated cirrhotic cases with SVR.

• Among 636 cirrhotic cases (65 years-old, 58% males), 480 formed Cohort A [CPT-A without previous liver-related events (LRE)], 89 formed Cohort B [CPT-B or CPT-A with prior non-hepatocellular carcinoma (HCC) LRE], 67 formed Cohort C (previous HCC).

• The 5-year estimated cumulative incidence of LRE was 10.4% in Cohort A vs 32.0% Cohort B [HCC 7.7% vs 19.7%; ascites 1.4% vs 8.6%; variceal bleeding 1.3% vs 7.8%; encephalopathy 0 vs 2.5%] vs 71% in Cohort C [HCC only].

• There appeared a strong influence of pretreatment liver disease history on long-term outcomes.

• After DAA cure, the most frequent liver-related event remained hepatocellular carcinoma.

• Due to improved long-term outcomes, exposure to a significant proportion of non-liver related events was recorded in SVR cirrhotic patients.

• Relative to the general population, stable compensated cirrhotic patients were similar in terms of mortality.