{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:13:55Z","timestamp":1783430035190,"version":"3.54.6"},"reference-count":50,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>The long\u2010term impact of HCV cure on hepatic and metabolic outcomes in patients with type 2 diabetes (T2D) remains insufficiently defined. This study evaluated T2D\u2010related vascular complications, liver disease progression and overall survival over 9\u2009years of follow\u2010up, also exploring genetic variability contribution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Consecutive T2D patients with HCV\u2010related chronic liver disease or cirrhosis treated with direct\u2010acting antivirals (DAAs) between 2015 and 2018 at the University Hospital of Messina were prospectively followed until September 2024. Demographic, biochemical, and clinical data were collected at baseline and throughout follow\u2010up. Regression models were applied to identify predictors of metabolic and hepatic outcomes. Genetic variants\u2014\n                      <jats:italic>PNPLA3<\/jats:italic>\n                      rs738409,\n                      <jats:italic>TM6SF2<\/jats:italic>\n                      rs58542926 and rs641738 at the\n                      <jats:italic>MBOAT7\/TMC4<\/jats:italic>\n                      locus\u2014were also assessed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 183 patients (52% males, median age 67\u2009years; 56% cirrhotic) were followed for a median of 48\u2009months (range 24\u201384). Despite significant improvements in HbA1c (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006), liver\u2010stiffness (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), gamma\u2010globulins (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and aminotransferases (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), only 27.3% maintained clinical stability. Liver disease progression occurred in 20.8% of patients and was related to cirrhosis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021), prior decompensation (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.07), and the MBOAT7 variant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.025). Macrovascular and microvascular complications developed in 50.8% and 33.9% of patients, respectively, mostly within 2\u2009years after SVR. In multivariate models, higher TyG index (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038) predicted the composite progression endpoint, while elevated LDL cholesterol (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048), mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although DAAs lead to metabolic and hepatic improvements, long\u2010term prognosis in T2D patients remains largely determined by baseline liver disease severity, insulin resistance, and genetic background. These findings emphasize the importance of early antiviral treatment and optimized metabolic management in this high\u2010risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70631","type":"journal-article","created":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T05:31:46Z","timestamp":1776490306000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From Cure to Complexity: Post\u2010\n                    <scp>SVR<\/scp>\n                    Liver and Metabolic Trajectories in Diabetic Patients"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0427-6963","authenticated-orcid":false,"given":"Clelia","family":"Asero","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Medicine University of Messina  Messina Italy"},{"name":"Medicine and Hepatology Unit University Hospital of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9815-5275","authenticated-orcid":false,"given":"Maria Stella","family":"Franz\u00e8","sequence":"additional","affiliation":[{"name":"Medicine and Hepatology Unit University Hospital of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Maltese","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine University of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"La Spada","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine University of Messina  Messina Italy"},{"name":"Unit of Nephrology and Dialysis University Hospital of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Lombardo","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine University of Messina  Messina Italy"},{"name":"Division of Advanced Diagnostic Laboratories University Hospital of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Grisanti","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine University of Messina  Messina Italy"},{"name":"Medicine and Hepatology Unit University Hospital of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4565-3131","authenticated-orcid":false,"given":"Giuseppina","family":"Russo","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine University of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Giandalia","sequence":"additional","affiliation":[{"name":"Department of Human Pathology of Adulthood and Childhood \u201cG. Barresi\u201d University of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Concetta","family":"Pitrone","sequence":"additional","affiliation":[{"name":"Medicine and Hepatology Unit University Hospital of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Filomia","sequence":"additional","affiliation":[{"name":"Medicine and Hepatology Unit University Hospital of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9755-5990","authenticated-orcid":false,"given":"Gaia","family":"Caccamo","sequence":"additional","affiliation":[{"name":"Medicine and Hepatology Unit University Hospital of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Saitta","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine University of Messina  Messina Italy"},{"name":"Medicine and Hepatology Unit University Hospital of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0383-6121","authenticated-orcid":false,"given":"Anna","family":"Licata","sequence":"additional","affiliation":[{"name":"Internal Medicine and Hepatology, PROMISE University Hospital of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Pollicino","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine University of Messina  Messina Italy"},{"name":"Division of Advanced Diagnostic Laboratories University Hospital of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7721-6799","authenticated-orcid":false,"given":"Irene","family":"Cacciola","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine University of Messina  Messina Italy"},{"name":"Medicine and Hepatology Unit University Hospital of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.08.018"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2024.07.032"},{"issue":"2","key":"e_1_2_12_4_1","first-page":"365","article-title":"Extrahepatic Manifestations of Chronic Hepatitis C Virus: Review of the Literature","volume":"19","author":"Stoenescu A. 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