Effects of Sofosbuvir/Velpatasvir Therapy on Extrahepatic Manifestations in Patients With Type 2 Diabetes and Chronic Hepatitis C: Insights From a Nationwide Hepatitis C Virus Registry in Taiwan

This study examines the impact of hepatitis C virus (HCV) eradication through sofosbuvir/velpatasvir (SOF/VEL) treatment on glycated hemoglobin (HbA1c) levels in patients with chronic hepatitis C and type 2 diabetes mellitus (T2DM). Utilizing data from the Taiwan HCV Registry, a retrospective analysis was conducted on 2180 patients who met the inclusion criteria, 695 of whom had T2DM. HbA1c levels significantly decreased in the diabetes group from 7.32% ± 1.72% at baseline to 6.87% ± 1.34% after achieving sustained virological response (SVR12). Patients with higher baseline HbA1c levels and cirrhosis experienced more pronounced HbA1c reductions. Among diabetic patients with HbA1c levels ≥ 6.5, 24.6% achieved levels < 6.5 following HCV elimination, while 24.4% of prediabetic patients observed HbA1c reductions < 5.7. Multivariate analysis identified fasting glucose levels and diabetes status as significant factors associated with HbA1c decline. These findings suggest that successful HCV treatment can improve glycemic control, highlighting the need for collaboration between hepatology and non-hepatology specialists in patient care.