Hsu, Wei-FanWei-FanHsuLai, Hsueh-ChouHsueh-ChouLaiChuang, Po-HengPo-HengChuangSu, Wen-PangWen-PangSuChen, Sheng-HungSheng-HungChenChen, Hung-YaoHung-YaoChenWang, Hung-WeiHung-WeiWangGUAN-TARN HUANGPeng, Cheng-YuanCheng-YuanPeng2024-03-262024-03-262022-0913520504https://www.scopus.com/record/display.uri?eid=2-s2.0-85131758639&doi=10.1111%2fjvh.13715&origin=inward&txGid=8b7d57dfe686c53d2e3507e7527fcb9fhttps://scholars.lib.ntu.edu.tw/handle/123456789/641385Patients with chronic hepatitis C (CHC) have a higher prevalence of hepatic steatosis and dyslipidaemia than healthy individuals. We analysed noninvasive fibrosis assessments, especially nonalcoholic fatty liver disease (NAFLD)-related noninvasive fibrosis tests, for predicting liver-related complications and hepatocellular carcinoma (HCC) occurrence in patients with CHC. This retrospective study enrolled 590 consecutive patients with CHC having a sustained virologic response (SVR) to direct-acting antiviral agent (DAA) therapy. The NAFLD fibrosis score (NFS) exhibiting the highest value of area under the receiver operating characteristic curve (AUROC) was selected for comparison with the fibrosis-4 index (FIB-4). Of the 590 patients, 188 had metabolic syndrome. A multivariate Cox regression analysis identified total bilirubin at 3 or 6 months after DAA therapy (PW12), NFS at PW12 (hazard ratio [HR]: 2.125, 95% confidence interval [CI]: 1.058-4.267, p = .034) and alpha-fetoprotein (AFP) at PW12 (HR: 1.071, 95% CI: 1.005-1.142, p = .034) as the independent predictors of liver-related complications in all patients. In patients with metabolic syndrome, NFS and AFP values at PW12 were independent predictors of liver-related complications and HCC occurrence. Time-dependent NFS AUROC values at PW12 for 1-, 2- and 3-year liver-related complications were higher than NFS values at baseline in patients with metabolic syndrome. NFS at baseline or PW12 is a more effective predictor of liver-related complications than FIB-4 values in all patients. NFS at PW12 may be a useful predictor of liver-related complications and HCC development in patients with CHC with an SVR to DAA therapy, especially in those with metabolic syndrome.enchronic hepatitis C; direct-acting antiviral agent; hepatocellular carcinoma; liver-related complication; nonalcoholic fatty liver disease fibrosis scorejournal article10.1111/jvh.13715356571212-s2.0-85131758639https://api.elsevier.com/content/abstract/scopus_id/85131758639