• Diagnosis of cirrhosis
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• West Haven score of ≥2 at study entry
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• Age ≥ 18 years
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• A mental health disorder that makes HE diagnosis questionable (e.g., dementia, psychosis)
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• Enrolment within 12 weeks of resolution of an episode of overt HE associated with a hospital visit
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• Prior treatment with rifaximina within 12 months prior to the qualifying overt HE episode
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• Ability to provide informed consent
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• Contraindications to the use of rifaximin-α 550 mg, as per the local Summary of Product Characteristics [16, 17]
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• Clinical eligibility to receive rifaximin-α 550 mg, in the opinion of the participating physician, regardless of HE treatment actually received
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