BCAA vs. Rifaximin in Patients With Cirrhosis for Secondary Prophylaxis of HE

Inclusion Criteria: 1. Cirrhosis defined by standard clinical, ultrasonographic findings and/or histological criteria. Cirrhosis of any etiology may be included. However, patients with cirrhosis due to autoimmune hepatitis must be on stable corticosteroid doses for ≥3-month period before study inclusion; those with viral hepatitis, must similarly be on anti-viral therapy with controlled viremia or with SVR. 2. Any gender 3. Discharged from the hospital following an episode of overt hepatic encephalopathy. 4. Participants able to give informed consent Exclusion Criteria: 1. Subjects with active bacterial or fungal infection 2. Subjects with active or very recent gastrointestinal bleeding in the last 2 weeks. 3. Current overt hepatic encephalopathy, defined as grade II-IV hepatic encephalopathy according to the West-Haven classification. 4. Conditions that can impact interpretation of cognitive function: i) Untreated viremic hepatitis C virus infection ii) Established neurological/degenerative disorders iii) Patient undergoing active alcohol withdrawal treatment Iv) Patient is intoxicated or under the influence of illicit drugs as per clinician assessment V) Treatment with antipsychotics or other psychotropic drugs with sedative effects 5. Patients with active hepatocellular carcinoma or history of hepatocellular carcinoma that is in remission for less than six months. 6. Patients with a history of significant extrahepatic disease with impaired short-term prognosis, including: i) Congestive heart failure New York Heart Association Grade III/IV or ejection fraction\<30% ii) COPD: GOLD \>2, ii) Chronic kidney disease with serum creatinine \>2mg/dL or under renal replacement therapy. 7. Patients with current extra hepatic malignancies, including solid tumours and hematologic disorders. 8. Patients with MELD\>20 9. Patients with mental incapacity, or those unlikely to survive 12 weeks or any other reason considered by the investigator precluding adequate understanding, cooperation, or compliance in the study activities. 10. Patients with TIPS shunt in situ 11. Pregnancy (urine pregnancy test at inclusion) 12. Refusal or inability to give informed consent