| The risk of liver cancer and liver-related or -unrelated death after SVR among patients with HCV has been not clear enough. We aimed to elucidate the association of metabolic abnormalities with liver cancer and prognosis after SVR with DAA by using multicenter, observational cohorts from 2014 to 2023 who had achieved SVR. The median number of follow-up was 3.8 years. Even after adjustment for diabetes, dyslipidemia, alcohol consumption, obesity, and fatty liver, high levels of Serum gamma-glutamyltransferase (GGT) after HCV elimination was associated with carcinogenesis (HR 2.70, p=0.022). Among groups without diabetes and alcohol drinking, male, older age, and higher SVR-GGT were associated with HCC development. The mortality rate among post-SVR patients without a history of HCC was 3.1%, and more deaths due to cardiovascular events or cancer of other organs were found than those from liver associated death. In patients with chronic hepatitis C under 70 years, elevated GGT and diabetes were independent factors associated with life prognosis after SVR. Patients with elevated GGT after SVR are at high risk of HCC regardless of their metabolic abnormalities and lifestyle, and are also at high risk of death including cardiovascular events and malignancies of other organs. GGT levels after SVR may reflect hepatitis C-specific oxidative stress as well as induction by lifestyle factors. |
