297), text (3634), references (29) + 1 supplementary material Ratio (HR)=2•77 (95% CI 2•07-3•71) and (HR=3•83 (2•29-6•42)), respectively. On adjusted multivariable analysis, exposure to DAA was associated with a decrease in all cause-mortality (HR=0•48 (95% CI 0•33-0•70)) and HCC (HR=0•66 (0•46-0•93)), and was no longer associated with decompensated cirrhosis (HR=1•14 (0•57-2•27)). InterpretationDAA treatment is associated with a reduced risk of mortality and HCC and should be considered in all patients with chronic HCV infection.

We believe that optimal management of these patients with chronic spontaneous encephalopathy is liver transplantation.