We read with interest the article published by Debes et al.1 These investigators observed that, in patients with hepatitis C-related cirrhosis, the serum levels of inflammatory cytokines before treatment and their modification with direct-acting antiviral (DAA) were associated with occurrence or recurrence of hepatocellular carcinoma (HCC). An additional hypothesis may be a dysregulation of the antitumor response after the sharp decrease in the hepatitis C viral load induced by DAA therapy, promoting tumor development.