Editorial
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Infect Dis. Feb 25, 2017; 7(1): 1-5
Published online Feb 25, 2017. doi: 10.5495/wjcid.v7.i1.1
Is it enough to eliminate hepatitis C virus to reverse the damage caused by the infection?
Patricia Pérez-Matute, José A Oteo
Patricia Pérez-Matute, José A Oteo, Infectious Diseases Department, Center for Biomedical Research of La Rioja (CIBIR)-Hospital San Pedro, 26006 Logroño, La Rioja, Spain
Author contributions: Pérez-Matute P and Oteo JA contributed to this paper.
Conflict-of-interest statement: Authors declare no conflict of interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: José A Oteo, MD, PhD, Head of the Infectious Disease Department, Center for Biomedical Research of La Rioja (CIBIR)-Hospital San Pedro, c/Piqueras, 98, 26006 Logroño, La Rioja, Spain. jaoteo@riojasalud.es
Telephone: +34-941-278871 Fax: +34-941-298667
Received: August 26, 2016
Peer-review started: August 27, 2016
First decision: October 28, 2016
Revised: November 18, 2016
Accepted: December 1, 2016
Article in press: December 2, 2016
Published online: February 25, 2017
Processing time: 181 Days and 11.7 Hours
Abstract

Hepatitis C virus (HCV) infection represents one of the major causes of chronic liver disease, hepatocellular carcinoma and morbidity/mortality worldwide. It is also a major burden to the healthcare systems. A complete elimination of the HCV from the body through treatment is now possible. However, HCV not only alters the hepatic function. Several extra-hepatic manifestations are present in HCV-infected patients, which increase the mortality rate. Liver and gut are closely associated in what is called the “gut-liver axis”. A disrupted gut barrier leads to an increase in bacterial translocation and an activation of the mucosal immune system and secretion of inflammatory mediators that plays a key role in the progression of liver disease towards decompensated cirrhosis in HCV-infected patients. In addition, both qualitative and quantitative changes in the composition of the gut microbiota (GM) and states of chronic inflammation have been observed in patients with cirrhosis. Thus, a successful treatment of HCV infection should be also accompanied by a complete restoration of GM composition in order to avoid activation of the mucosal immune system, persistent inflammation and the development of long-term complications. Evaluation of GM composition after treatment could be of interest as a reliable indicator of the total or partial cure of these patients. However, studies focused on microbiota composition after HCV eradication from the body are lacking, which opens unique opportunities to deeply explore and investigate this exciting field.

Keywords: Hepatitis C infection; Inflammation; Virus eradication; Direct-acting antivirals; Gut microbiota

Core tip: Hepatitis C infection represents one of the major causes of chronic liver disease, hepatocellular carcinoma and morbidity/mortality worldwide. A complete elimination of the hepatitis C virus (HCV) from the body through treatment is now possible. However, HCV not only alters the hepatic function. In fact, changes in gut microbiota composition (GM) and gut barrier that leads to an increased bacterial translocation and inflammation have also been observed. Thus, a successful treatment of HCV infection should be accompanied by a complete restoration of GM and inflammation. Studies focused on GM after HCV eradication are lacking, which opens unique opportunities to deeply explore this exciting field.