Compared to ALT normalization within 6 months, postponed ALT normalizations at 6–12, 12–24, and >24 months were related to a significantly increased HCC risk (AHR 1.40, 1.74, and 2.45, respectively; p < 0.001), irrespective of steatosis or cirrhosis at the baseline and VR during therapy. Here, GPT is linked to Cirrhosis.