Gut dysbiosis associated with hepatitis C virus infection

Takako Inoue, Jiro Nakayama, Kei Moriya, Hideto Kawaratani, Rie Momoda, Kiyoaki Ito, Etsuko Iio, Shunsuke Nojiri, Kei Fujiwara, Masashi Yoneda, Hitoshi Yoshiji, Yasuhito Tanaka

Research output: Contribution to journalArticlepeer-review

123 Citations (Scopus)


Background. Little is known about the effect of hepatitis C virus (HCV) infection on gut microbiota and the relationship between alteration of gut microbiota and chronic hepatitis C (CHC) progression. We performed a comparative study of gut microbiota composition between CHC patients and healthy individuals. Methods. Fecal samples from 166 CHC patients were compared with those from 23 healthy individuals; the gut microbiota community was analyzed using 16S ribosomal RNA gene sequencing. CHC patients were diagnosed with persistently normal serum alanine aminotransferase without evidence of liver cirrhosis (LC) (PNALT, n = 18), chronic hepatitis (CH, n = 84), LC (n = 40), and hepatocellular carcinoma in LC (n = 24). Results. Compared with healthy individuals, bacterial diversity was lower in persons with HCV infection, with a decrease in the order Clostridiales and an increase in Streptococcus and Lactobacillus. Microbiota dysbiosis already appeared in the PNALT stage with the transient increase in Bacteroides and Enterobacteriaceae. Predicted metagenomics of microbial communities showed an increase in the urease gene mainly encoded by viridans streptococci during CHC progression, consistent with a significantly higher fecal pH in CH and LC patients than in healthy individuals or those in the PNALT stage. Conclusions. HCV infection is associated with gut dysbiosis, even in patients with mild liver disease. Additionally, overgrowth of viridans streptococci can account for hyperammonemia in CH and LC. Further studies would help to propose a novel treatment strategy because the gut microbiome can be therapeutically altered, potentially reducing the complications of chronic liver disease.

Original languageEnglish
Pages (from-to)869-877
Number of pages9
JournalClinical Infectious Diseases
Issue number6
Publication statusPublished - Aug 31 2018

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases


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