Citation: Meunier, L.; Belkacemi, M.; Pageaux, G.P.; Radenne, S.; Vallet-Pichard, A.; Houssel-Debry, P.; Duvoux, C.; Botta-Fridlund, D.; de Ledinghen, V.; Conti, F.; et al. Patients Treated for HCV Infection and Listed for Liver Transplantation in a French Multicenter Study: What Happens at Five Years? Viruses 2023, 15, 137. https://doi.org/10.3390/v15010137 Academic Editors: Joseph Doyle and Amanda Wade Received: 14 December 2022 Accepted: 26 December 2022 Published: 31 December 2022 Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). viruses Article Patients Treated for HCV Infection and Listed for Liver Transplantation in a French Multicenter Study: What Happens at Five Years? Lucy Meunier 1, * , Mohamed Belkacemi 2 , George Philippe Pageaux 1 , Sylvie Radenne 3 , Anaïs Vallet-Pichard 4 , Pauline Houssel-Debry 5 , Christophe Duvoux 6 , Danielle Botta-Fridlund 7 , Victor de Ledinghen 8 , Filomena Conti 9 , Rodolphe Anty 10 , Vincent Di Martino 11 , Marilyne Debette-Gratien 12 , Vincent Leroy 13 , Theophile Gerster 13 , Pascal Lebray 9 , Laurent Alric 14 , Armand Abergel 15 ,Jérôme Dumortier 16 , Camille Besch 17 , Helene Montialoux 18 , Didier Samuel 19 , Jean-Charles Duclos-Vallée 19 and Audrey Coilly 19 1 Montpellier Saint Eloi University Hospital, 80 Avenue Augustin Fliche, 34090 Montpellier, France 2 Nouvelles Technologies, AESIO Santé, 34070 Montpellier, France 3 Croix-Rousse Hospital, Lyon University Hospital, 103 Grande Rue de la Croix-Rousse, 69004 Lyon, France 4 Cochin Hospital, Public Hospitals of Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France 5 Pontchaillou University Hospital, 2 Rue Henri le Guilloux, 35000 Rennes, France 6 Henri-Mondor University Hospital, Public Hospitals of Paris, 51 Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France 7 Marseille Public Hospital, Timone University Hospital, 264 Rue Saint Pierre, 13005 Marseille, France 8 Hepatology and Liver Transplantation Unit, Haut-Lévêque Hospital, Bordeaux University Hospital, 33600 Pessac, France 9 Pitié-Salpêtrière University Hospital, Public Hospitals of Paris, 47-83 Boulevard de l’Hôpital, 75013 Paris, France 10 Archet 2 Hospital, Nice University Hospital, 151 Route de Saint-Antoine, 06200 Nice, France 11 Besançon Regional University Hospital, 3 Boulevard Alexandre Fleming, 25000 Besançon, France 12 Limoges University Hospital, 2 Avenue Martin Luther King, 87000 Limoges, France 13 Service d’Hépato-Gastroentérologie, Pôle Digidune, CHU Grenoble Alpes, 38700 La Tronche, France 14 Rangueil Hospital, Toulouse 3 University Hospital, 31000 Toulouse, France 15 Gabriel-Montpied Hospital, Clermont-Ferrand University Hospital, 58 Rue Montalembert, 63000 Clermont-Ferrand, France 16 Edouard Herriot Hospital, Lyon University Hospital, 5 Place d’Arsonval, 69003 Lyon, France 17 Hautepierre Hospital, Strasbourg University Hospital, 1 Avenue Molière, 67200 Strasbourg, France 18 Rouen University Hospital, 37 Boulevard Gambetta, 76000 Rouen, France 19 Paul-Brousse Hospital, Public Hospsitals of Paris, 12 Avenue Paul Vaillant Couturier, FHU Hépatinov, 94800 Villejuif, France * Correspondence: lucy.meunier@chu-montpellier.fr Abstract: Background: Direct-acting antiviral (DAA) agents for the treatment of hepatitis C virus (HCV) infection have been proven safe and effective in cirrhotic patients awaiting liver transplantation (LT). However, in the long term, data remain minimal regarding the clinical impact of viral eradication on patients listed for decompensated cirrhosis or hepatocellular carcinoma (HCC). We aimed to elucidate the clinical outcomes of patients regarding delisting and the evolution of HCC during the long-term follow-up. Methods: An observational, multicenter, retrospective analysis was carried out on prospectively collected data from HCV-positive patients treated with an interferon-free regimen while awaiting LT in 18 French hospitals. Results: A total of 179 patients were included in the study. The indication for LT was HCC in 104 (58.1%) patients and cirrhosis in 75 (41.9%) patients. The sustained virological response was 84.4% and the treatment was well tolerated. At five years, among 75 patients with cirrhosis treated for HCV, 19 (25.3%) were delisted following improvement after treatment. Predictive factors for delisting highlighted an absence of ascites, MELD score ≤ 15, and Child–Pugh score ≤ 7. No patients with refractory ascites were delisted. Among patients with HCC, 82 (78.9%) were transplanted. The drop-out rate was low (6.7%) and few recurrences of HCC after LT were observed. Conclusions: DAAs are safe and effective in patients awaiting LT for cirrhosis or HCC. A quarter of patients with cirrhosis can be delisted because of clinical improvement. Predictive factors Viruses 2023, 15, 137. https://doi.org/10.3390/v15010137 https://www.mdpi.com/journal/viruses