Gut microbiome dysbiosis in hepatocellular carcinoma patients with persistent HCV viremia versus viral clearance: a cross-sectional study
Abstract
Hepatocellular carcinoma (HCC) remains a lethal complication of chronic hepatitis C virus (HCV) infection, even after successful direct-acting antiviral (DAA) therapy. The gut microbiome influences hepatocarcinogenesis through the gut‒liver axis; however, the microbial signatures associated with HCC in DAA-treated patients are poorly defined. This study aimed to elucidate the patterns of microbiomes in HCV-treated patients who developed HCC, with a focus on bacterial diversity, differentially represented taxa, and their associations with clinical markers (FIB-4) and metabolic profiles as potential biomarkers. A total of 138 participants were enrolled: 46 HCC patients with persistent HCV viremia (RHCC), 46 HCC patients with HCV eradication (THCC), and 46 healthy controls. RHCC patients exhibited pronounced dysbiosis, characterized by reduced alpha diversity (Kruskal–Wallis; H = 14.37, p = 0.00076) and an elevated Firmicutes/Bacteroidetes (F/B) ratio (1.55 vs. 1.05 in controls; Mann–Whitney U test, U = 87.32, padj = 0.00079). At the genus level, Asteroleplasma was significantly enriched in RHCC (log₂FC = + 2.8, padj = 0.008), whereas the butyrate-producing genus Faecalibacterium was depleted (log₂FC = − 2.1, padj = 0.006). Machine learning identified Asteroleplasma, Moryella, Lachnoclostridium, Fournierella, Eubacterium xylanophilum, Succinivibrio, and Faecalibacterium as the top classifiers of RHCC (AUC = 0.81). Functional profiling revealed a 58% reduction in butyrate…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 138 participants or records.
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