Components of cardiometabolic risk factors predict liver-related events in patients cured of hepatitis C Virus.

[BACKGROUND] 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.

[METHODS] 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.

[RESULTS] 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.

[CONCLUSIONS] 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.