Rosato V, Ascione A, Nevola R, et al. - Patients achieving viral clearance after direct-acting anti-HCV therapy show a progressive, long-term decline in liver stiffness (LS), indicating a late improvement in liver fibrosis, alongside the resolution of inflammation.

• A multicenter prospective study involving 516 patients with HCV infection treated with DAAs.

• Clinical, biochemical, ultrasound and transient elastography evaluations were performed on participants before treatment (T0), 12 weeks (SVR12) and 24 months (T24) after the end of therapy.

• 301 of 516 patients had cirrhosis.

• From T0 to SVR, there was a significant reduction in LS (14.3 vs 11.1 kPa), with a progressive reduction until T24 (8.7 kPa).

• Late reduction of LS appeared to be hindered by fatty liver and the development of HCC.

• Risk for developing HCC appeared to be higher for patients with an LS ≥ 14 kPa at 12 weeks after the end of treatment.