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This study demonstrates that reduced bacterial richness and dysbiosis escalate with the progression of cirrhosis from compensated to decompensated cirrhosis and to HCC-associated cirrhosis (HCC-cirrhosis). Moreover, we report for the first time the effect of environmental factors on HCC-cirrhosis. Excess weight was associated with increased dysbiosis in patients with HCC compared to their normal-weight counterparts. Moreover, fatty liver, consumption of artificial sweeteners, and high-sugar foods were associated with altered microbial composition, including altered levels of\n            <jats:named-content content-type=\"genus-species\">Akkermansia muciniphila<\/jats:named-content>\n            in HCC-cirrhosis. We have successfully determined that levels of\n            <jats:italic>Alphaproteobacteria<\/jats:italic>\n            and the two genera\n            <jats:italic>CF231<\/jats:italic>\n            and\n            <jats:italic>Clostridium<\/jats:italic>\n            are significantly altered in cirrhotic patients who develop hepatocellular carcinoma, independently of cirrhosis severity and dietary habits.\n          <\/jats:p>","DOI":"10.1128\/msystems.00153-20","type":"journal-article","created":{"date-parts":[[2020,6,15]],"date-time":"2020-06-15T14:17:52Z","timestamp":1592230672000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":96,"title":["Alterations in the Gut Microbiome in the Progression of Cirrhosis to Hepatocellular Carcinoma"],"prefix":"10.1128","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7776-6069","authenticated-orcid":false,"given":"Yelena","family":"Lapidot","sequence":"first","affiliation":[{"name":"Liver Research Laboratory, Sheba Medical Center, Tel Hashomer, Israel"},{"name":"Liver Diseases Center, Sheba Medical Center, Tel Hashomer, Israel"},{"name":"The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amnon","family":"Amir","sequence":"additional","affiliation":[{"name":"Cancer Research Center, Sheba Medical Center, Tel Hashomer, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Nosenko","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Bar-Ilan University, Safed, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atara","family":"Uzan-Yulzari","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Bar-Ilan University, Safed, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ella","family":"Veitsman","sequence":"additional","affiliation":[{"name":"Liver Diseases Center, Sheba Medical Center, Tel Hashomer, Israel"},{"name":"Liver Diseases Center, Rambam Health Care Campus, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oranit","family":"Cohen-Ezra","sequence":"additional","affiliation":[{"name":"Liver Diseases Center, Sheba Medical Center, Tel Hashomer, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yana","family":"Davidov","sequence":"additional","affiliation":[{"name":"Liver Diseases Center, Sheba Medical Center, Tel Hashomer, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peretz","family":"Weiss","sequence":"additional","affiliation":[{"name":"Liver Diseases Center, Sheba Medical Center, Tel Hashomer, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya","family":"Bradichevski","sequence":"additional","affiliation":[{"name":"Liver Diseases Center, Sheba Medical Center, Tel Hashomer, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shlomo","family":"Segev","sequence":"additional","affiliation":[{"name":"Medical Screening Unit, Sheba Medical Center, Tel Hashomer, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omry","family":"Koren","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Bar-Ilan University, Safed, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Safran","sequence":"additional","affiliation":[{"name":"Liver Research Laboratory, Sheba Medical Center, Tel Hashomer, Israel"},{"name":"Liver Diseases Center, Sheba Medical Center, Tel Hashomer, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziv","family":"Ben-Ari","sequence":"additional","affiliation":[{"name":"Liver Research Laboratory, Sheba Medical Center, Tel Hashomer, Israel"},{"name":"Liver Diseases Center, Sheba Medical Center, Tel Hashomer, Israel"},{"name":"The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","volume-title":"Cancer","author":"World Health Organization","year":"2018","unstructured":"World Health Organization. 2018. 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