with the introduction of Direct-acting antiviral agents in the management of HCV, the scope of inclusion criteria had been widened to include patients with compensated cirrhosis and even in special situations patients with decompensated liver disease; a chance that was not offered by the limited and strict inclusion criteria needed for treatment by pegylated interferon-based regimen. this made the number of patients with progressive liver fibrosis of cirrhosis had been inv=creased even after achieving SVR. the debate about the impact of SVR on halting fibrosis progression had risen; some studies postulated that patients benefit from an SVR through reduction of mortality, morbidity, and improved quality of life ; however, some patients may maintain their level of fibrosis or even progress to cirrhosis despite achieving SVR and the risk for HCC remains even after virologic eradication.

Inclusion Criteria:

• chronic HCV
• compensated liver disease (Child class A-B)
• sustained virological response
• liver stiffness by fibroscan >12.5 kPa denotes cirrhosis

Exclusion Criteria:

• decompensated liver disease
• chronic active HCV
• hepatocellular carcinoma
• other liver diseases as alcoholic liver disease, autoimmune liver disease, drug-induced liver disease
• pregnancy