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Page 10 of 12                                         Rutledge et al. Hepatoma Res 2019;5:31  I  http://dx.doi.org/10.20517/2394-5079.2019.19

               pre-existing risk factors for HCC development were treated with DAA. This imbalance would appear to
               explain the higher numerical incidence of de novo HCC among DAA-treated patients. Given the success
               and cost-effectiveness of DAA therapy for the treatment of HCV infection [47-49] , clinicians should not be
               dissuaded by prior studies that suggest an increased risk of precipitating HCC development, as this seems
               to largely be a product of the presence of more advanced liver disease and increased risk factors among
               DAA-treated patients. Rather, the practice of continued surveillance for HCC for those persons with
               baseline risk factors, should continue to be reinforced.


               DECLARATIONS
               Authors’ contributions
               Contributed to the final version of the manuscript: Rutledge SM, Li DK, Chung RT
               Performed the statistical analysis: Zheng H
               Supervised the project: Chung RT

               Availability of data and materials
               Not applicable.

               Financial support and sponsorship
               Raymond T. Chung received grant support (NIH grant DK078772).


               Conflicts of interest
               All authors declared that there are no conflicts of interest.

               Ethical approval and consent to participate
               Not applicable.


               Consent for publication
               Not applicable.


               Copyright
               © The Author(s) 2019.



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