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Patients with advanced liver disease caused by hepatitis B virus (HBV) have significantly different gut microbiota compared to healthy individuals.¹

A team, led by Meng-Ju Lin, School of Medicine, College of Medicine, National Taiwan University, examined the gut microbiota of a subset of patients with liver disease and compared the results to a healthy control group.

“Hepatitis B virus (HBV) causes chronic hepatitis B (CHB), liver cirrhosis, and hepatocellular carcinoma,” the authors wrote. “The evolution of human gut microbiota during the progression of HBV-related liver diseases remains unclear.”

Patients With Liver Disease

In the study, the investigators enrolled patients with HBV-related liver diseases, as well as a healthy control group.

The team characterized the gut microbiota of participants and predicted the functions of microbial communities through 16S ribosomal RNA amplicon sequencing.

After analyzing the gut microbiota of the 56 participant control group and the 106 patients with HBV-related liver disease, the investigators found patients with HBV-related liver disease exhibited a higher degree of bacterial richness (all P <0.05) than did healthy controls.

Of the patients with liver disease, 14 had resolved HBV infections, 58 had CHB, and 34 had advanced liver disease, 15 of which had liver cirrhosis and 19 had hepatocellular carcinoma.

The median age of the healthy control was 28 years, compared to 57 years for the resolved HBV group, 51 years for the CHB patients, and 62 years for patients with advanced liver disease (P <0.0001).

A beta diversity analyses revealed a distinct clustering pattern between healthy controls and patients with HBV-related liver disease (all P <0.05) and the composition of bacteria from the phylum level to the genus level varies across the stages of liver disease.

The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen, creatinine, and fasting blood glucose were higher for the resolved HBV group, those with CHB, and patients with advanced liver disease than in the healthy control group (all P <0.0001).

Linear discriminant analysis effect size showed multiple taxa that differ significantly in abundance between the 2 groups, but fewer differences found among patients with resolved HBV infection, those with CHB, and those with advanced liver disease.

The ratio of Firmicutes to Bacteroidetes increased in all 3 patient groups compared to the ratio found in the healthy control group (all P <0.001).

There were changes in microbial functions with disease progression found in the analysis of the sequencing data by using PICRUSt2.

“The diversity and composition of gut microbiota appear to vary significantly between healthy controls and patients at different stages of HBV-related liver disease,” the authors wrote. “The understanding of gut microbiota may provide novel therapeutic options in these patients.”

References:

Lin, MJ., Su, TH., Chen, CC. et al. Diversity and composition of gut microbiota in healthy individuals and patients at different stages of hepatitis B virus-related liver disease. Gut Pathog 15, 24 (2023). https://doi.org/10.1186/s13099-023-00549-w