{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T23:29:12Z","timestamp":1787614152896,"version":"build-2736575974"},"reference-count":108,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hepatocellular carcinoma (HCC) poses a major global health burden, and diabetic patients remain at high risk even after achieving a sustained virological response (SVR) to hepatitis C virus (HCV) with direct-acting antivirals (DAAs). Gut microbiome dysbiosis is implicated in this heightened risk, but the microbial characteristics and underlying mechanisms remain poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a cross-sectional study of 81 adults divided into three groups (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200927 each): (1) diabetic patients with HCC after SVR (DHCC), (2) diabetic patients without HCC after SVR, and (3) healthy controls. Stool samples and clinical data were collected approximately 3 years post-SVR. Microbial diversity, taxonomic composition, and predicted metabolic functions were analyzed and correlated with clinical markers of liver disease.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      DHCC patients exhibited marked microbial dysbiosis, including reduced alpha diversity (Chao1,\n                      <jats:italic>p\u2009=<\/jats:italic>\n                      0.003) and significant ecological disruption (Kruskal\u2013Wallis,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). The key features included enrichment of\n                      <jats:italic>Treponema_2<\/jats:italic>\n                      (log\u2082FC\u2009=\u20097.71,\n                      <jats:italic>padj<\/jats:italic>\n                      &amp;lt; 0.001) and\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      (AUC\u2009=\u20090.88) and depletion of the butyrate-producing genus\n                      <jats:italic>Faecalibacterium<\/jats:italic>\n                      (2.08% vs. 9.99% in controls,\n                      <jats:italic>p\u2009=<\/jats:italic>\n                      0.006). Functional analysis revealed a 56% reduction in butyrate synthesis and a 3.2-fold increase in lipopolysaccharide biosynthesis. These shifts correlated with clinical severity:\n                      <jats:italic>Treponema_2<\/jats:italic>\n                      abundance was associated with hepatic encephalopathy and AST levels, whereas reduced butyrate inversely correlated with FIB-4 scores. Random forest modeling identified\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      ,\n                      <jats:italic>Enterobacter<\/jats:italic>\n                      , and\n                      <jats:italic>Megasphaera<\/jats:italic>\n                      as the top predictors of DHCC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Diabetic patients with HCC after HCV eradication exhibit a persistent gut microbiome signature characterized by proinflammatory and carcinogenic features. These findings highlight potential targets for microbiome-based risk stratification and therapeutic interventions in this high-risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmicb.2025.1693345","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T06:42:20Z","timestamp":1767940940000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["The gut microbiome in diabetic patients with hepatocellular carcinoma: distinct bacterial compositional shifts after hepatitis C virus eradication"],"prefix":"10.3389","volume":"16","author":[{"given":"Mohammed","family":"Ramadan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim A.","family":"Amin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed E.","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman R.","family":"Abdelbary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helal F.","family":"Hetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roba","family":"Alatawy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fawaz E.","family":"Alanazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Alattar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem","family":"Alshaman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasser","family":"Alatawi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Salah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1007\/s12072-018-9868-8","article-title":"Efficacy and safety of sofosbuvir plus daclatasvir with or without ribavirin: large real-life results of patients with chronic hepatitis C genotype 4","volume":"12","author":"Abdel-Moneim","year":"2018","journal-title":"Hepatol. 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