We examined 1388 patients with chronic liver disease type C without liver cancer history who achieved sustained virological response for 24 weeks or more (SVR24) with direct acting antiviral (DAA) treatment. We assessed the carcinogenic status and investigated liver carcinogenesis predictors. Overall, we identified 39 patients with liver cancer for a cancer rate of 2.8%. We identified the FIB4 index at SVR24 determination as a liver carcinogenesis marker and determined its cutoff value at 3.06. The survival prognosis after achieving SVR was significantly worse in patients with liver carcinogenesis than in those without it. The cumulative risk at 1 year and 6 months after DAA treatment was also higher in patients with liver carcinogenesis (0.055) than in those without it (0.002). The onset of liver cancer is associated with prognosis after achieving SVR; therefore, early detection and treatment of liver cancer are necessary to improve the prognosis of these patients.
