Is direct-acting antiviral treatment beneficial or harmful for patients with hepatitis C virus-related hepatocellular carcinoma?

Whether direct-acting antiviral (DAA) treatment can prevent hepatocellular carcinoma (HCC) recurrence is a subject of debate. In a prior study, Ahn et al. 1 investigated cases of hepatitis C virus (HCV)-related HCC in patients who received curative treatment using a nationwide database; spe-cifically, the authors investigated whether DAA therapy following curative HCC treatment decreased the likelihood of HCC recurrence compared to interferon (IFN)-based thera-pies or no treatment. 1 Notably, several studies have shown an unexpectedly high rate of early HCC recurrence in patients with HCV-related HCC following DAA treatment. 2 Addi-tionally, in a landmark analysis, DAA treatment significantly reduced all-cause mortality compared to no treatment at 6 and 12 months after the first HCC treatment. Several questions remain unanswered in the DAA era: the first concerns the optimal time to start DAA