Lee, Shou-WuShou-WuLeeYang, Sheng-ShunSheng-ShunYangTsai, Pei-ChienPei-ChienTsaiHuang, Chung-FengChung-FengHuangChen, Chi-YiChi-YiChenHung, Chao-HungChao-HungHungCHIEN-HUNG CHENTai, Chi-MingChi-MingTaiCheng, Pin-NanPin-NanChengKuo, Hsing-TaoHsing-TaoKuoTseng, Kuo-ChihKuo-ChihTsengMo, Lein-RayLein-RayMoLo, Ching-ChuChing-ChuLoHuang, Yi-HsiangYi-HsiangHuangLin, Han-ChiehHan-ChiehLinLee, Pei-LunPei-LunLeeBair, Ming-JongMing-JongBairChang, Te-ShengTe-ShengChangLin, Chun-YenChun-YenLinWang, Szu-JenSzu-JenWangHsieh, Tsai-YuanTsai-YuanHsiehYang, Tzeng-HueTzeng-HueYangPeng, Cheng-YuanCheng-YuanPengYang, Chi-ChiehChi-ChiehYangChong, Lee-WonLee-WonChongHuang, Chien-WeiChien-WeiHuangLin, Chih-WenChih-WenLinChu, Cheng-HsinCheng-HsinChuTsai, Ming-ChangMing-ChangTsaiJIA-HORNG KAOChuang, Wan-LongWan-LongChuangCHUN-JEN LIULee, Teng-YuTeng-YuLeeYu, Ming-LungMing-LungYu2025-11-112025-11-112025-07https://scholars.lib.ntu.edu.tw/handle/123456789/733630Background/Aims: The survival benefit of direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV) infection in patients with hepatocellular carcinoma (HCC), particularly in Barcelona Clinic Liver Cancer (BCLC) stages B/C, remains largely uncertain. We aimed to explore the impact of DAA therapy on overall survival (OS) in HCC patients using a nationwide cohort study. Methods: We utilized the nationwide Taiwan Association for the Study of the Liver (TASL) HCV Registry (TACR) database to include all adults receiving a DAA therapy for HCV, excluding those with other viral infections, liver transplantation, non-HCC malignancies, and terminal-staged HCC. We respectively analyzed the adjusted odds ratio (aOR) for sustained virological response (SVR) and adjusted hazard ratio (aHR) for OS. Results: Between December 2013 and December 2020, 2,205 (9.3%) patients with HCC and 21,569 (90.7%) patients without HCC were include. The SVR rates were 96.6% in the HCC group and 98.8% in the non-HCC group (P<0.001), with HCC being an independent risk factor affecting SVR (aOR 0.41; 95% CI 0.31–0.54; P<0.001). In the whole patient cohort, SVR was independently associated with improved OS (aHR 0.46; 95% CI 0.35–0.60; P<0.001). Among patients with baseline HCC, SVR remained an independent factor related to OS (aHR 0.41; 95% CI 0.28–0.59; P<0.001). The impact of SVR on OS persisted significantly across BCLC stages 0/A and stages B/C. Conclusions: High SVR rates among HCC patients underscore the importance of DAA therapy in enhancing OS, reaffirming its efficacy across various HCC stages.enAntiviralsChronic hepatitis CLiver cancerSurvivalSustained virological response[SDGs]SDG3journal article10.3350/cmh.2024.101539905837