Fibrosis changes following viral clearance and its relation to HCC

Globally, about 290 000 people died from hepatitis C (HCV) in 2019, mostly from cirrhosis and hepatocellular carcinoma (HCC). Less than a decade, direct-acting antivirals (DAAs) replaced interferon-based therapies in treatment protocols and sustained virologic response (SVR) rates exceeded 95%. However, it is not clear yet whether HCV eradication by DAAs can reverse fibrosis or cirrhosis substantially, reduce the risk of developing HCC in the long term. In this review was aimed to summarizes the evidence for reversibility or progression of fibrosis following HCV clearance by DAAs, subsequently its impact on developing de nova HCC. For this purpose, cohorts in which patients achieved SVR, have paired liver stiffness measurements obtained by transient elastography were reviewed and results discussed.