Components of Cardiometabolic Risk Factors Predict Liver-Related Events in Patients Cured of Hepatitis C Virus

The new nomenclature of steatotic liver disease (SLD) was proposed in June 2023. The effects of cardiometabolic risk factors (CMRFs) on liver-related events (LREs) in patients achieving chronic hepatitis C (CHC) eradication are unknown. This study recruited 1185 patients cured of CHC. CMRFs and alcohol consumption were clearly defined. Variables obtained at 12 or 24 weeks after direct-acting antiviral therapy (PW12) were used to identify the predictors of LREs. A total of 562 patients (47.4 %) had metabolic dysfunction-associated SLD (MASLD), 96 (8.1 %) had MASLD with increased alcohol intake, 14 (1.2 %) had alcohol-related liver disease, 78 (6.6 %) had cryptogenic SLD, and 435 (36.7 %) had no SLD. Multivariable Cox regression analysis indicated that age, alcohol consumption, per CMRF (hazard ratio: 1.332, 95 % confidence interval: 1.094-1.621), posttreatment albumin level, alpha-fetoprotein level, and fibrosis-4 index >3.25 were independent predictors of LREs. Another multivariable analysis revealed that prediabetes and diabetes mellitus were predictors of LREs. The new fatty liver disease nomenclature of SLD was used to stratify the risk of LREs in patients achieving CHC eradication. The risk of LREs increased by 33 % per CMRF, and prediabetes or DM was a predictor of LREs.