Features of the gut microbiota in patients with severe liver fibrosis and cirrhosis associated with chronic hepatitis C

Objective : to characterize specific changes in the intestinal microbiome profile associated with progressive liver fibrosis in patients with chronic HCV infection Materials and methods : a single-center cross-sectional clinical study of 88 patients with chronic HCV infection (51 people with chronic viral hepatitis C and 37 people with liver cirrhosis of viral C etiology) was conducted, in which the profile of the gut microbiota was determined by 16S rRNA metagenomic sequencing. High-throughput sequencing was performed using a MiSeq genetic analyzer (Illumina, USA) using a protocol based on the analysis of variable regions of the 16S rRNA gene. The data was analyzed using Kraken2. The significance level is assumed to be 0,05. Results : significant changes in gut microbial diversity have been described in patients with severe liver fibrosis and cirrhosis. In patients with progressive fibrosis, there was a significant increase in representatives of the Enterobacteriaceae, Lactobacillus, Streptococcus, Enterococcus, Lactococcus and Leuconostoc families. Atypical microorganisms such as Photobacterium, Spiroplasma, Candidatus Portiera are also noted in the gut microbiota. The combination of these changes indicates a shift in microbial equilibrium. On the contrary, in the group of patients without liver fibrosis, there is an increase in the number of Odoribacter and Intestinimonas, which are butyrate producers. As well as Akkermansia and Barnesiella, which indicates the normal functioning of the intestinal microbial community. Conclusions: changes in the intestinal microbiota in severe fibrosis result in the formation of a stable and self-sustaining pathological microbial community. The identified changes can be used to develop corrective methods aimed at restoring the balance of the intestinal microbiota.