Hepatitis C Virus Infection Linked to Gut Dysbiosis

intestine bacteria
intestine bacteria
Bacterial diversity was lower in patients infected with hepatitis C virus compared with healthy individuals.

Hepatitis C virus (HCV) infection is associated with gut dysbiosis, and the microbiome transition could be a biological indicator of chronic hepatitis C progression in patients with mild liver disease, according to a study published in Clinical Infectious Diseases.1

The gut microbiota is closely associated with the progression of liver diseases,2 and previous studies indicate that gut dysbiosis affects chronic liver disease,3-6 including the most severe forms (ie, cirrhosis and hepatocellular carcinoma).7,8 However, there are few data on the effect of HCV infection on gut microbiota and the relationship between gut dysbiosis and chronic hepatitis C progression.

Therefore, researchers compared the gut microbiota from 166 patients with chronic hepatitis C with those from 23 healthy individuals, using 16S ribosomal RNA gene sequencing of fecal samples.1 The researchers found that in patients with HCV infection, bacterial diversity was lower compared with in healthy individuals, and there was a decrease in the order Clostridiales and an increase in Streptococcus and Lactobacillus.

However, gut dysbiosis was evident in patients with HCV through a transient increase in Enterobacteriaceae and Bacteroides, which occurred even in patients with mild liver disease. The researchers also found that overgrowth of viridans streptococci can account for hyperammonemia in patients with chronic hepatitis and liver cirrhosis.

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The authors concluded that, “HCV infection is associated with gut dysbiosis, even in patients with mild liver disease.”1 Thus, the findings of this study may help in developing therapies for controlling gut microbiota, such as the use of pre- and probiotics or fecal microbiota transplantation to prevent chronic hepatitis C progression.


  1. Inoue T, Nakayama J, Moriya K, et al. Gut dysbiosis associated with hepatitis C virus infection [published online May 1, 2018]. Clin Infect Dis. doi: 10.1093/cid/ciy205
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  4. Zhu L, Baker SS, Gill C, et al. Characterization of gut microbiomes in nonalcoholic steatohepatitis (NASH) patients: a connection between endogenous alcohol and NASH. Hepatology. 2013;57:601-609.
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  8. Gómez-Hurtado I, Santacruz A, Peiró G, et al. Gut microbiota dysbiosis is associated with inflammation and bacterial translocation in mice with CCl4-induced fibrosis. PLoS One. 2011;6:e23037.