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Letter to the Editor: Steatotic liver disease in chronic hepatitis C - a marker of systemic risk, not direct-acting antiviral treatment failure
Abdo Imad El Tawil, Department of Medical Research, Faculdade Evangélica Mackenzie do Paraná, Curitiba 80730-000, Paraná, Brazil
Claudia Alexandra Pontes Ivantes, Department of Internal Medicine, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba 80810-070, Paraná, Brazil
Author contributions: El Tawil AI wrote the original draft; Ivantes CAP contributed to the conceptualization, writing, reviewing, and editing; El Tawil AI and Ivantes CAP participated in drafting the manuscript; all authors have read and approved the final version of the manuscript.
AI contribution statement: OpenEvidence was the AI tool used for literature search and identification of relevant scientific references, mainly by addressing important recent updates on the theme we comment on in our work. ChatGPT was used for language polishing, stylistic refinement, and improvement of textual clarity. Paperpal was the AI tool used for professional grammar assessment, as being a recognized program for this activity. Additionally, no AI tools were used to generate scientific hypotheses, study design, data interpretation, or the scientific conclusions of this manuscript.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Corresponding author: Abdo Imad El Tawil, Principal Investigator, Researcher, Department of Medical Research, Faculdade Evangélica Mackenzie do Paraná, Rua Padre Anchieta 2770, Curitiba 80730-000, Paraná, Brazil. abdoieltawil@gmail.com
Received: December 8, 2025
Revised: February 8, 2026
Accepted: March 31, 2026
Published online: June 27, 2026
Processing time: 193 Days and 13.8 Hours
Revised: February 8, 2026
Accepted: March 31, 2026
Published online: June 27, 2026
Processing time: 193 Days and 13.8 Hours
Core Tip
Core Tip: This letter discusses the real-world findings of Janczura et al, who evaluated the impact of steatotic liver disease on chronic hepatitis C virus infection in the era of direct-acting antivirals. Their work highlights how metabolic dysfunction, aging, and genotype-specific characteristics contribute to persistent liver risk despite viral cure. By emphasizing the role of noninvasive steatosis assessment in identifying high-risk patients and guiding long-term monitoring, this correspondence reinforces the clinical relevance of steatotic liver disease in shaping the prognosis and follow-up strategies for individuals with current or past hepatitis C virus infection.