Restoration of the gut-microbiota-liver axis after hepatitis C virus eradication

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Background & Aims: We previously reported altered intestinal environmental features during HCV infection. Here, we aimed to characterize the gut-microbiota-liver axis in patients with chronic hepatitis C after a sustained virological response (SVR). Methods: A total of 174 patients with HCV infection were enrolled in a cross-sectional study: 95 with chronic hepatitis (CH-HCV group) and 79 with cirrhosis or hepatocellular carcinoma (LC/HCC-HCV group). In addition, 75 post-SVR patients were included (CH-SVR group, n = 29; LC/HCC-SVR group, n = 46), along with 23 healthy individuals. A longitudinal study was subsequently conducted on 49 patients (CH, n = 29; LC/HCC, n = 20) with SVR at 24 and 48 weeks after the end of treatment. RNA sequencing was performed on 65 patients with HCV infection, 28 post-SVR patients, and 12 healthy controls. Results: = 0.0344, respectively), suggesting a beneficial role in liver recovery. Conclusion: The gut-microbiota-liver axis is partially restored following HCV eradication, with recovery from liver damage associated with the resurgence of commensal Lachnospiraceae species. Impact and implications: , as well as a rebalancing of the fecal bile acid profile. These changes are closely associated with significant improvements in liver fibrosis and function, highlighting a potential role of the gut microbiota in liver recovery and regeneration.

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