The article by Kanwal et al1 in the October issue of Gastroenterology is of utmost importance. It clearly shows that the cure of chronic infection by hepatitis C virus with direct-acting antivirals reduced the risk of developing hepatocellular carcinoma (HCC) by 76%.1 Nevertheless, one-fourth of cured patients succumbed to this cancer; hence, other mechanisms should be suspected to be active in these patients. One such pathogenetic agent was identified to be strongly associated with HCC in either hepatitis C virus and hepatitis B virus–positive patients both in Europe and in China, namely the infection by pathogenic Helicobacter pylori.