Influence of hepatitis C virus eradication with direct-acting antivirals on the gut microbiota in patients with cirrhosis

Francesca Romana Ponziani, Lorenza Putignani, Francesco Paroni Sterbini, Valentina Petito, Anna Picca, Federica Del Chierico, Sofia Reddel, Riccardo Calvani, Emanuele Marzetti, Maurizio Sanguinetti, Antonio Gasbarrini, Maurizio Pompili

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
JournalAlimentary Pharmacology and Therapeutics
DOIs
Publication statusE-pub ahead of print - Oct 22 2018

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Hepacivirus
Antiviral Agents
Fibrosis
Virus Diseases
Liver Cirrhosis
Inflammation
Permeability
Enterococcus
Enterobacteriaceae
Therapeutics
Staphylococcus
Chemokines
Gastrointestinal Microbiome
Healthy Volunteers
Cytokines
Bacteria
Liver
Serum

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Influence of hepatitis C virus eradication with direct-acting antivirals on the gut microbiota in patients with cirrhosis. / Ponziani, Francesca Romana; Putignani, Lorenza; Paroni Sterbini, Francesco; Petito, Valentina; Picca, Anna; Del Chierico, Federica; Reddel, Sofia; Calvani, Riccardo; Marzetti, Emanuele; Sanguinetti, Maurizio; Gasbarrini, Antonio; Pompili, Maurizio.

In: Alimentary Pharmacology and Therapeutics, 22.10.2018.

Research output: Contribution to journalArticle

Ponziani, Francesca Romana ; Putignani, Lorenza ; Paroni Sterbini, Francesco ; Petito, Valentina ; Picca, Anna ; Del Chierico, Federica ; Reddel, Sofia ; Calvani, Riccardo ; Marzetti, Emanuele ; Sanguinetti, Maurizio ; Gasbarrini, Antonio ; Pompili, Maurizio. / Influence of hepatitis C virus eradication with direct-acting antivirals on the gut microbiota in patients with cirrhosis. In: Alimentary Pharmacology and Therapeutics. 2018.
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abstract = "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.",
author = "Ponziani, {Francesca Romana} and Lorenza Putignani and {Paroni Sterbini}, Francesco and Valentina Petito and Anna Picca and {Del Chierico}, Federica and Sofia Reddel and Riccardo Calvani and Emanuele Marzetti and Maurizio Sanguinetti and Antonio Gasbarrini and Maurizio Pompili",
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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

N1 - © 2018 John Wiley & Sons Ltd.

PY - 2018/10/22

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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.

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