TY - JOUR
T1 - Influence of hepatitis C virus eradication with direct-acting antivirals on the gut microbiota in patients with cirrhosis
AU - Ponziani, Francesca Romana
AU - Putignani, Lorenza
AU - Paroni Sterbini, Francesco
AU - Petito, Valentina
AU - Picca, Anna
AU - Del Chierico, Federica
AU - Reddel, Sofia
AU - Calvani, Riccardo
AU - Marzetti, Emanuele
AU - Sanguinetti, Maurizio
AU - Gasbarrini, Antonio
AU - Pompili, Maurizio
PY - 2018
Y1 - 2018
N2 - Background: The cure of hepatitis C virus (HCV) infection may contribute to the reduction of liver fibrosis progression and potentially influence the gut-liver axis. Aim: To investigate the influence of HCV infection eradication with direct-acting antivirals (DAAs) on the gut microbiota composition as well as on intestinal and systemic inflammatory parameters in patients with cirrhosis. Methods: Consecutive patients with HCV-related cirrhosis receiving DAA treatment were included. The gut microbiota composition, intestinal permeability, and inflammation were assessed before treatment and after 1 year. Clinical outcomes such as episodes of decompensation and markers of liver fibrosis were evaluated over a 2-year follow-up period. Results: The gut microbiota alpha diversity in cirrhotic patients, which was lower than that in healthy subjects, was significantly improved by the cure of HCV infection and a shift in the overall gut microbiota composition was observed compared to baseline. The abundance of potentially pathogenic bacteria (Enterobacteriaceae, Enterococcus, and Staphylococcus) was decreased after treatment. The gut microbiota composition was associated with the inflammatory profile and markers of liver fibrosis. Although a significant reduction in the serum levels of cytokines and chemokines was observed post-DAA treatment, measures of intestinal permeability and inflammation remained unchanged. Conclusions: Cure of HCV infection with DAAs in patients with cirrhosis is associated with a modification of the gut microbiota, which correlates with fibrosis and inflammation but does not improve intestinal barrier function.
AB - Background: The cure of hepatitis C virus (HCV) infection may contribute to the reduction of liver fibrosis progression and potentially influence the gut-liver axis. Aim: To investigate the influence of HCV infection eradication with direct-acting antivirals (DAAs) on the gut microbiota composition as well as on intestinal and systemic inflammatory parameters in patients with cirrhosis. Methods: Consecutive patients with HCV-related cirrhosis receiving DAA treatment were included. The gut microbiota composition, intestinal permeability, and inflammation were assessed before treatment and after 1 year. Clinical outcomes such as episodes of decompensation and markers of liver fibrosis were evaluated over a 2-year follow-up period. Results: The gut microbiota alpha diversity in cirrhotic patients, which was lower than that in healthy subjects, was significantly improved by the cure of HCV infection and a shift in the overall gut microbiota composition was observed compared to baseline. The abundance of potentially pathogenic bacteria (Enterobacteriaceae, Enterococcus, and Staphylococcus) was decreased after treatment. The gut microbiota composition was associated with the inflammatory profile and markers of liver fibrosis. Although a significant reduction in the serum levels of cytokines and chemokines was observed post-DAA treatment, measures of intestinal permeability and inflammation remained unchanged. Conclusions: Cure of HCV infection with DAAs in patients with cirrhosis is associated with a modification of the gut microbiota, which correlates with fibrosis and inflammation but does not improve intestinal barrier function.
KW - Gastroenterology
KW - Hepatology
KW - Pharmacology (medical)
KW - Gastroenterology
KW - Hepatology
KW - Pharmacology (medical)
UR - http://hdl.handle.net/10807/129570
UR - http://onlinelibrary.wiley.com/journal/10.1111/(issn)1365-2036
U2 - 10.1111/apt.15004
DO - 10.1111/apt.15004
M3 - Article
SN - 0269-2813
VL - 48
SP - 1301
EP - 1311
JO - ALIMENTARY PHARMACOLOGY & THERAPEUTICS
JF - ALIMENTARY PHARMACOLOGY & THERAPEUTICS
ER -