Changes of Gut-Microbiota-Liver Axis in Hepatitis C Virus Infection

Abstract

The gut-liver-axis is a bidirectional coordination between the gut, including microbial residents, the gut microbiota, from one side and the liver on the other side. Any disturbance in this crosstalk may lead to a disease status that impacts the functionality of both the gut and the liver. A major cause of liver disorders is hepatitis C virus (HCV) infection that has been illustrated to be associated with gut microbiota dysbiosis at different stages of the disease progression. This dysbiosis may start a cycle of inflammation and metabolic disturbance that impacts the gut and liver health and contributes to the disease progression. This review discusses the latest literature addressing this interplay between the gut microbiota and the liver in HCV infection from both directions. Additionally, we highlight the contribution of gut microbiota to the metabolism of antivirals used in HCV treatment regimens and the impact of these medications on the microbiota composition. This review shed light on the potential of the gut microbiota manipulation as an alternative therapeutic approach to control the liver complications post HCV infection.

Keywords: HCV; antiviral drugs; dysbiosis; gut liver axis; gut microbiota.

Figure 1

Gut microbiota dysbiosis in HCV and its hypothetical contribution to the progression of gut–liver axis complications.

Figure 2

Microbiota–gut–liver axis in HCV infection. HCV is associated with gut microbiota dysbiosis and distortion of bile acid metabolism, which overtime promote liver complications and cross talk with HCV treatment regimens. All these factors affect the enterophepatic axis homeostasis, however, the cause–effect relationship is lacking and requires further comprehensive analysis.