直接抗病毒药物对慢性丙型肝炎患者肠道微生物群的影响。

Effects of direct anti-viral agents on the gut microbiota in patients with chronic hepatitis C.

作者信息

Huang Pao-Yuan, Chen Chien-Hung, Tsai Mu-Jung, Yao Chih-Chien, Wang Hsin-Ming, Kuo Yuan-Hung, Chang Kuo-Chin, Hung Chao-Hung, Chuah Seng-Kee, Tsai Ming-Chao

机构信息

Division of Hepato-gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.

Division of Hepato-gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.

出版信息

J Formos Med Assoc. 2023 Feb;122(2):157-163. doi: 10.1016/j.jfma.2022.08.022. Epub 2022 Sep 23.

DOI:10.1016/j.jfma.2022.08.022

PMID:36155707

Abstract

BACKGROUND/PURPOSE: Gut microbiology is associated with liver disease due to gut-liver circulation via the gut microbial-liver axis. There is a paucity of data regarding the effects of treatment to cure hepatitis C virus (HCV) infection on the gut microbiota. The aim of this study was to evaluate the fecal microbiota before and after treatment with direct antiviral agents (DAA) in patients with HCV infection.

METHODS

This prospective study was conducted at Kaohsiung Chung-Gung Memorial Hospital, Taiwan, between December 2019 and November 2020. We recruited patients with chronic hepatitis C (CHC) receiving DAA treatment. Fecal samples were collected twice: at baseline (before DAA treatment; CHC group) and 24 weeks after the end of treatment (EOT; SVR24 group), and once from healthy controls at baseline (control group). The taxonomic composition of the gut microbiota was determined using 16 S ribosomal RNA gene sequencing of stool samples.

RESULTS

A total of 60 patients with CHC and 60 healthy controls matched by age and gender were enrolled. All patients achieved a sustained virologic response (SVR). Alpha diversity was not significantly difference between any groups. Analysis of similarities (ANOSIM) revealed minor differences in the microbial community structure between the control group and CHC group (R = 0.0146, P = 0.098) and less significant differences between the CHC group and SVR24 group (R = -0.0139; P = 0.94). Three phyla and eight genera were differentially abundant between the control group and CHC group.

CONCLUSION

Individuals with CHC do not exhibit significant gut microbiota alterations and eradication of HCV by DAA is not associated with significant modification of the gut microbiota.

摘要

背景/目的：肠道微生物群通过肠道微生物-肝脏轴的肠肝循环与肝脏疾病相关。关于丙型肝炎病毒（HCV）感染治愈治疗对肠道微生物群影响的数据较少。本研究的目的是评估HCV感染患者使用直接抗病毒药物（DAA）治疗前后的粪便微生物群。

方法

这项前瞻性研究于2019年12月至2020年11月在台湾高雄中广纪念医院进行。我们招募了接受DAA治疗的慢性丙型肝炎（CHC）患者。粪便样本采集两次：基线时（DAA治疗前；CHC组）和治疗结束后24周（EOT；SVR24组），并在基线时从健康对照者中采集一次（对照组）。使用粪便样本的16S核糖体RNA基因测序确定肠道微生物群的分类组成。

结果

共纳入60例CHC患者和60例年龄和性别匹配的健康对照者。所有患者均实现了持续病毒学应答（SVR）。任何组之间的α多样性均无显著差异。相似性分析（ANOSIM）显示对照组和CHC组之间的微生物群落结构存在微小差异（R = 0.0146，P = 0.098），CHC组和SVR24组之间的差异较小（R = -0.0139；P = 0.94）。对照组和CHC组之间有三个门和八个属的丰度存在差异。