{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T22:47:48Z","timestamp":1793227668599,"version":"4.5.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T00:00:00Z","timestamp":1613520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100002873","name":"Chulalongkorn University","doi-asserted-by":"publisher","award":["RA62-033"],"award-info":[{"award-number":["RA62-033"]}],"id":[{"id":"10.13039\/501100002873","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004396","name":"Thailand Research Fund","doi-asserted-by":"publisher","award":["RTA6280004"],"award-info":[{"award-number":["RTA6280004"]}],"id":[{"id":"10.13039\/501100004396","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002873","name":"Chulalongkorn University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002873","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P20GM125503"],"award-info":[{"award-number":["P20GM125503"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The influence of direct-acting antivirals (DAAs) on the composition of gut microbiota in hepatitis C virus (HCV)\u2013infected patients with or without human immunodeficiency virus (HIV) is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiab094","type":"journal-article","created":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T07:19:11Z","timestamp":1613114351000},"page":"1410-1421","source":"Crossref","is-referenced-by-count":13,"title":["Improvement of Gut Diversity and Composition After Direct-Acting Antivirals in Hepatitis C Virus\u2013Infected Patients With or Without Human Immunodeficiency Virus Coinfection"],"prefix":"10.1093","volume":"224","author":[{"given":"Natthaya","family":"Chuaypen","sequence":"first","affiliation":[{"name":"Center of Excellence in Hepatitis and Liver Cancer, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thananya","family":"Jinato","sequence":"additional","affiliation":[{"name":"Center of Excellence in Hepatitis and Liver Cancer, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anchalee","family":"Avihingsanon","sequence":"additional","affiliation":[{"name":"The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakkarin","family":"Chirapongsathorn","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, Phramongkutklao Hospital, College of Medicine, Royal Thai Army, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supapon","family":"Cheevadhanarak","sequence":"additional","affiliation":[{"name":"Systems Biology and Bioinformatics Research Group, Pilot Plant Development and Training Institute, King Mongkut\u2019s University of Technology Thonburi, Bangkok, Thailand"},{"name":"School of Bioresources and Technology, King Mongkut\u2019s University of Technology Thonburi, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8901-1088","authenticated-orcid":false,"given":"Intawat","family":"Nookaew","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhito","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pisit","family":"Tangkijvanich","sequence":"additional","affiliation":[{"name":"Center of Excellence in Hepatitis and Liver Cancer, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,2,17]]},"reference":[{"key":"2021103113410420100_CIT0001","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1016\/S0140-6736(19)32320-7","article-title":"Hepatitis C","volume":"394","author":"Spearman","year":"2019","journal-title":"Lancet"},{"key":"2021103113410420100_CIT0002","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1038\/nrgastro.2016.176","article-title":"Global epidemiology and burden of HCV infection and HCV-related disease","volume":"14","author":"Thrift","year":"2017","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"2021103113410420100_CIT0003","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1038\/s41575-018-0011-z","article-title":"The gut-liver axis and the intersection with the microbiome","volume":"15","author":"Tripathi","year":"2018","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"2021103113410420100_CIT0004","first-page":"369","article-title":"Hepatic decompensation in antiretroviral-treated patients co-infected with HIV and hepatitis C virus compared with hepatitis C virus-monoinfected patients: a cohort study","volume":"160","author":"Lo Re","year":"2014","journal-title":"Ann Intern Med"},{"key":"2021103113410420100_CIT0005","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1053\/j.gastro.2018.10.033","article-title":"What are the benefits of a sustained virologic response to direct-acting antiviral therapy for hepatitis C virus infection?","volume":"156","author":"Ioannou","year":"2019","journal-title":"Gastroenterology"},{"key":"2021103113410420100_CIT0006","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1016\/j.jhep.2019.10.003","article-title":"The gut-liver axis in liver disease: pathophysiological basis for therapy","volume":"72","author":"Albillos","year":"2020","journal-title":"J Hepatol"},{"key":"2021103113410420100_CIT0007","doi-asserted-by":"crossref","first-page":"e32028","DOI":"10.1371\/journal.pone.0032028","article-title":"Circulating sCD14 is associated with virological response to pegylated-interferon-alpha\/ribavirin treatment in HIV\/HCV co-infected patients","volume":"7","author":"Marchetti","year":"2012","journal-title":"PLoS One"},{"key":"2021103113410420100_CIT0008","doi-asserted-by":"crossref","first-page":"2035","DOI":"10.1136\/gutjnl-2016-312729","article-title":"Gut microbiome and liver diseases","volume":"65","author":"Tilg","year":"2016","journal-title":"Gut"},{"key":"2021103113410420100_CIT0009","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1055\/s-0037-1602763","article-title":"The human gut microbiome in liver diseases","volume":"37","author":"Davis","year":"2017","journal-title":"Semin Liver Dis"},{"key":"2021103113410420100_CIT0010","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1093\/cid\/ciy205","article-title":"Gut dysbiosis associated with hepatitis C virus infection","volume":"67","author":"Inoue","year":"2018","journal-title":"Clin Infect Dis"},{"key":"2021103113410420100_CIT0011","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1111\/liv.13485","article-title":"Intestinal microbiota in patients with chronic hepatitis C with and without cirrhosis compared with healthy controls","volume":"38","author":"Heidrich","year":"2018","journal-title":"Liver Int"},{"key":"2021103113410420100_CIT0012","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1111\/apt.13732","article-title":"HCV eradication does not impact gut dysbiosis or systemic inflammation in cirrhotic patients","volume":"44","author":"Bajaj","year":"2016","journal-title":"Aliment Pharmacol Ther"},{"key":"2021103113410420100_CIT0013","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1111\/apt.15004","article-title":"Influence of hepatitis C virus eradication with direct-acting antivirals on the gut microbiota in patients with cirrhosis","volume":"48","author":"Ponziani","year":"2018","journal-title":"Aliment Pharmacol Ther"},{"key":"2021103113410420100_CIT0014","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.ejim.2019.06.005","article-title":"Short-term effects of direct-acting antiviral agents on inflammation and gut microbiota in hepatitis C-infected patients","volume":"67","author":"P\u00e9rez-Matute","year":"2019","journal-title":"Eur J Intern Med"},{"key":"2021103113410420100_CIT0015","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1148\/radiol.2016160209","article-title":"Liver stiffness measurements with MR elastography: agreement and repeatability across imaging systems, field strengths, and pulse sequences","volume":"281","author":"Trout","year":"2016","journal-title":"Radiology"},{"key":"2021103113410420100_CIT0016","doi-asserted-by":"crossref","first-page":"291","DOI":"10.2463\/mrms.11.291","article-title":"Magnetic resonance elastography for staging liver fibrosis in chronic hepatitis C","volume":"11","author":"Ichikawa","year":"2012","journal-title":"Magn Reson Med Sci"},{"key":"2021103113410420100_CIT0017","doi-asserted-by":"crossref","first-page":"16112","DOI":"10.1038\/nmicrobiol.2016.112","article-title":"Raising standards in microbiome research","volume":"1","year":"2016","journal-title":"Nat Microbiol"},{"key":"2021103113410420100_CIT0018","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1038\/nmeth.3869","article-title":"DADA2: high-resolution sample inference from Illumina amplicon data","volume":"13","author":"Callahan","year":"2016","journal-title":"Nat Methods"},{"key":"2021103113410420100_CIT0019","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1038\/nmeth.f.303","article-title":"QIIME allows analysis of high-throughput community sequencing data","volume":"7","author":"Caporaso","year":"2010","journal-title":"Nat Methods"},{"key":"2021103113410420100_CIT0020","doi-asserted-by":"crossref","first-page":"R60","DOI":"10.1186\/gb-2011-12-6-r60","article-title":"Metagenomic biomarker discovery and explanation","volume":"12","author":"Segata","year":"2011","journal-title":"Genome Biol"},{"key":"2021103113410420100_CIT0021","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1038\/nbt.2676","article-title":"Predictive functional profiling of microbial communities using 16S rRNA marker gene sequences","volume":"31","author":"Langille","year":"2013","journal-title":"Nat Biotechnol"},{"key":"2021103113410420100_CIT0022","doi-asserted-by":"crossref","first-page":"D109","DOI":"10.1093\/nar\/gkr988","article-title":"KEGG for integration and interpretation of large-scale molecular data sets","volume":"40","author":"Kanehisa","year":"2012","journal-title":"Nucleic Acids Res"},{"key":"2021103113410420100_CIT0023","doi-asserted-by":"crossref","first-page":"1972","DOI":"10.3389\/fmicb.2019.01972","article-title":"Association between impaired V\u03b17.2+CD161++CD8+ (MAIT) and V\u03b17.2+CD161-CD8+ T-Cell populations and gut dysbiosis in chronically HIV- and\/or HCV-infected patients","volume":"10","author":"Merlini","year":"2019","journal-title":"Front Microbiol"},{"key":"2021103113410420100_CIT0024","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/s13099-016-0124-2","article-title":"Gut microbiome alterations in patients with stage 4 hepatitis C","volume":"8","author":"Aly","year":"2016","journal-title":"Gut Pathog"},{"key":"2021103113410420100_CIT0025","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1016\/j.jhep.2013.01.003","article-title":"Modulation of the fecal bile acid profile by gut microbiota in cirrhosis","volume":"58","author":"Kakiyama","year":"2013","journal-title":"J Hepatol"},{"key":"2021103113410420100_CIT0026","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1038\/nature13568","article-title":"Alterations of the human gut microbiome in liver cirrhosis","volume":"513","author":"Qin","year":"2014","journal-title":"Nature"},{"key":"2021103113410420100_CIT0027","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1053\/j.gastro.2011.06.063","article-title":"Host response to translocated microbial products predicts outcomes of patients with HBV or HCV infection","volume":"141","author":"Sandler","year":"2011","journal-title":"Gastroenterology"},{"key":"2021103113410420100_CIT0028","doi-asserted-by":"crossref","first-page":"ofz255","DOI":"10.1093\/ofid\/ofz255","article-title":"Bacterial translocation and host immune activation in chronic hepatitis C infection","volume":"6","author":"Moon","year":"2019","journal-title":"Open Forum Infect Dis"},{"key":"2021103113410420100_CIT0029","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1002\/cpt.363","article-title":"Complexities of gut microbiome dysbiosis in the context of HIV infection and antiretroviral therapy","volume":"99","author":"Li","year":"2016","journal-title":"Clin Pharmacol Ther"},{"key":"2021103113410420100_CIT0030","doi-asserted-by":"crossref","first-page":"2409","DOI":"10.1097\/QAD.0000000000000869","article-title":"Gut microbiota diversity predicts immune status in HIV-1 infection","volume":"29","author":"Nowak","year":"2015","journal-title":"AIDS"},{"key":"2021103113410420100_CIT0031","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1126\/science.1110591","article-title":"Diversity of the human intestinal microbial flora","volume":"308","author":"Eckburg","year":"2005","journal-title":"Science"},{"key":"2021103113410420100_CIT0032","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.ebiom.2016.01.032","article-title":"Gut microbiota linked to sexual preference and HIV infection","volume":"5","author":"Noguera-Julian","year":"2016","journal-title":"EBioMedicine"},{"key":"2021103113410420100_CIT0033","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1093\/infdis\/jiy136","article-title":"Eradication of hepatitis C virus (HCV) reduces immune activation, microbial translocation, and the HIV DNA level in HIV\/HCV-coinfected patients","volume":"218","author":"Lopez-Cortes","year":"2018","journal-title":"J Infect Dis"},{"key":"2021103113410420100_CIT0034","doi-asserted-by":"crossref","DOI":"10.1093\/infdis\/jiaa109","article-title":"HCV cure in HIV coinfection dampens inflammation and improves cognition through multiple mechanisms","author":"Sun","year":"2020","journal-title":"J Infect Dis"},{"key":"2021103113410420100_CIT0035","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1080\/0036554021000026946","article-title":"Eubacterium bacteremia and colon cancer","volume":"34","author":"Sungkanuparph","year":"2002","journal-title":"Scand J Infect Dis"},{"key":"2021103113410420100_CIT0036","doi-asserted-by":"crossref","first-page":"1690","DOI":"10.1002\/hep.30690","article-title":"Fecal microbial transplant capsules are safe in hepatic encephalopathy: a phase 1, randomized, placebo-controlled trial","volume":"70","author":"Bajaj","year":"2019","journal-title":"Hepatology"},{"key":"2021103113410420100_CIT0037","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1097\/00004836-200603000-00015","article-title":"Colonic health: fermentation and short chain fatty acids","volume":"40","author":"Wong","year":"2006","journal-title":"J Clin Gastroenterol"},{"key":"2021103113410420100_CIT0038","doi-asserted-by":"crossref","first-page":"e17447","DOI":"10.1371\/journal.pone.0017447","article-title":"Metatranscriptomic approach to analyze the functional human gut microbiota","volume":"6","author":"Gosalbes","year":"2011","journal-title":"PLoS One"},{"key":"2021103113410420100_CIT0039","doi-asserted-by":"crossref","first-page":"2325","DOI":"10.1194\/jlr.R036012","article-title":"The role of short-chain fatty acids in the interplay between diet, gut microbiota, and host energy metabolism","volume":"54","author":"den Besten","year":"2013","journal-title":"J Lipid Res"},{"key":"2021103113410420100_CIT0040","doi-asserted-by":"crossref","first-page":"3122","DOI":"10.3892\/etm.2017.4878","article-title":"Phascolarctobacterium faecium abundant colonization in human gastrointestinal tract","volume":"14","author":"Wu","year":"2017","journal-title":"Exp Ther Med"},{"key":"2021103113410420100_CIT0041","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/j.jhep.2018.03.026","article-title":"EASL recommendations on treatment of hepatitis C 2018","volume":"69","author":"European Association for the Study of the Liver","year":"2018","journal-title":"J Hepatol"},{"key":"2021103113410420100_CIT0042","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1001\/jamainternmed.2015.6011","article-title":"Cost-effectiveness of early treatment of hepatitis C virus genotype 1 by stage of liver fibrosis in a US treatment-naive population","volume":"176","author":"Chahal","year":"2016","journal-title":"JAMA Intern Med"},{"key":"2021103113410420100_CIT0043","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1080\/17512433.2018.1447923","article-title":"Treatment of early stage chronic hepatitis C virus infection","volume":"11","author":"Ponziani","year":"2018","journal-title":"Expert Rev Clin Pharmacol"},{"key":"2021103113410420100_CIT0044","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1016\/j.jhep.2019.07.021","article-title":"Sustained virological response from interferon-based hepatitis C regimens is associated with reduced risk of extrahepatic manifestations","volume":"71","author":"Rossi","year":"2019","journal-title":"J Hepatol"},{"key":"2021103113410420100_CIT0045","doi-asserted-by":"crossref","first-page":"2037","DOI":"10.1007\/s00261-017-1211-7","article-title":"Evaluation of hepatic fibrosis: a review from the Society of Abdominal Radiology Disease Focus Panel","volume":"42","author":"Horowitz","year":"2017","journal-title":"Abdom Radiol (NY)"},{"key":"2021103113410420100_CIT0046","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1053\/j.gastro.2020.04.077","article-title":"Contribution of the intestinal microbiome and gut barrier to hepatic disorders","volume":"159","author":"Chopyk","year":"2020","journal-title":"Gastroenterology"}],"container-title":["The Journal of Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jid\/advance-article-pdf\/doi\/10.1093\/infdis\/jiab094\/37055966\/jiab094.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jid\/article-pdf\/224\/8\/1410\/40978963\/jiab094.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jid\/article-pdf\/224\/8\/1410\/40978963\/jiab094.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,31]],"date-time":"2021-10-31T09:41:43Z","timestamp":1635673303000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jid\/article\/224\/8\/1410\/6141513"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,17]]},"references-count":46,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,2,17]]},"published-print":{"date-parts":[[2021,10,28]]}},"URL":"https:\/\/doi.org\/10.1093\/infdis\/jiab094","relation":{},"ISSN":["0022-1899","1537-6613"],"issn-type":[{"value":"0022-1899","type":"print"},{"value":"1537-6613","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,10,15]]},"published":{"date-parts":[[2021,2,17]]}}}