- OBJECTIVE: The continued risk of hepatocellular cancer (HCC) following HCV clearance by direct-acting antivirals (DAAs), even if a sustained viral response (SVR) is achieved, has been previously reported. This study's objective was to identify biochemical predictors for HCC occurrence in patients who achieved HCV clearance by DAA treatment af-ter one year.PATIENTS AND METHODS: Patients who achieved SVR at week 24 with DAA between No-vember 2015 and January 2021 and had no ev-idence of HCC were evaluated retrospective-ly. Biochemical parameters such as serum AFP (Alpha-fetoprotein), AST (Aspartate Aminotrans-ferase), ALT (Alanine aminotransferase), albu-min, PLT (platelet) count, FIB-4 and APRI index-es (non-invasive fibrosis indexes) were analyzed before starting the DAA treatment, at the end of the treatment (EOT), and 24th-week post -treat-ment.RESULTS: Throughout a median follow-up time of 43 +/- 16.2 months, it was observed that HCC occurred in 14 (5.6%) of 248 CHC pa-tients who reached SVR at the 24th week after DAA treatment. According to multivariate anal-ysis, AFP levels were >7.08 ng/ml before treat-ment (HR, 3.8; p=0.050), >5.15 ng/ml at the EOT (HR, 6.8; p=0.019), and >5.68 ng/ml at the 24th week post-treatment (HR, 21.2; p=0.002); albu-min levels were <3.75 g/dl before treatment (HR, 3.6; p=0.042), <4.05 g/dl at the EOT (HR, 6.9; p=0.005), and <4.15 g/dl at week 24 post -treat-ment (HR, 8.8; p=0.002); PLT counts <153.000/ mm3 at the 24th week post-treatment (HR, 12.1; p=0.001) were determined to be independent biochemical predictors for the development of HCC after one year of ending DAA treatment.CONCLUSIONS: AFP and albumin levels be-fore treatment, at the EOT, and post-treatment at week 24, and PLT numbers at week 24 post-treatment can be used to foresee the risk of developing HCC one year after ending of DAA treatment.