Improvement of Gut Diversity and Composition After Direct-Acting Antivirals in Hepatitis C Virus-Infected Patients With or Without Human Immunodeficiency Virus Coinfection.

Abstract

BACKGROUND:

The influence of direct-acting antivirals (DAAs) on the composition of gut microbiota in hepatitis C virus (HCV)-infected patients with or without human immunodeficiency virus (HIV) is unclear.

METHODS:

We enrolled 62 patients with HCV monoinfection and 24 patients with HCV/HIV coinfection receiving elbasvir-grazoprevir from a clinical trial. Fecal specimens collected before treatment and 12 weeks after treatment were analyzed using amplicon-based 16S ribosomal RNA sequencing.

RESULTS:

Sustained virological response rates in the monoinfection and coinfection groups were similar (98.4% vs 95.8%). Pretreatment bacterial communities in the patient groups were less diverse and distinct from those of healthy controls. Compared with HCV-monoinfected patients, HCV/HIV-coinfected individuals showed comparable microbial alpha diversity but decreased Firmicutes-Bacteroidetes ratios. The improvement of microbial dysbiosis was observed in responders achieving sustained virological response across fibrosis stages but was not found in nonresponders. Responders with a low degree of fibrosis exhibited a recovery in alpha diversity to levels comparable to those in healthy controls. Reciprocal alterations of increased beneficial bacteria and reduced pathogenic bacteria were also observed in responders.

CONCLUSIONS:

This study indicates a short-term effect of direct-acting antivirals in restoration of microbial dysbiosis. The favorable changes in gut microbiota profiles after viral eradication might contribute toward the reduction of HCV-related complications among infected individuals.

• Authors: Natthaya Chuaypen, Thananya Jinato, Anchalee Avihingsanon, Sakkarin Chirapongsathorn, Supapon Cheevadhanarak, Intawat Nookaew, Yasuhito Tanaka, Pisit Tangkijvanich
• Journal: The Journal of infectious diseases (J Infect Dis) Vol. 224 Issue 8 Pg. 1410-1421 (10 28 2021) ISSN: 1537-6613 [Electronic] United States
• PMID: 33598686 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: [email protected].

Chemical References

• Antiviral Agents
• Benzofurans
• Drug Combinations
• Imidazoles
• Quinoxalines
• elbasvir-grazoprevir drug combination

Topics

• Adult
• Aged
• Antiviral Agents (adverse effects, therapeutic use)
• Benzofurans (therapeutic use)
• Coinfection (drug therapy)
• Drug Combinations
• Drug-Related Side Effects and Adverse Reactions
• Dysbiosis (complications, drug therapy)
• Female
• Gastrointestinal Microbiome
• HIV Infections (complications, drug therapy)
• Hepacivirus
• Hepatitis C (complications, drug therapy)
• Humans
• Imidazoles (therapeutic use)
• Male
• Middle Aged
• Quinoxalines (therapeutic use)
• Treatment Outcome
• Viral Load