中西医结合肝病杂志2025，Vol.35Issue(10)：1195-1203,9.DOI:10.3969/j.issn.1005-0264.2025.010.002
HBV不同感染状态的慢性乙型肝炎患者肠道菌群组成及差异研究
Composition and differences of gut microbiota in chronic hepatitis B patients with various HBV infection states
摘要
Abstract
Objective:This study aimed to delineate how the intestinal microbiota of chronic hepatitis B(CHB)patients correlates with two pivotal virological indices:quantitative HBsAg titers and HBeAg seroconversion status.Methods:A cross-sectional study was conducted in 94 entecavir-treated CHB patients.Gut microbiota was profiled by 16S rRNA gene sequencing.Participants were stratified into six subgroups according to(i)quantitative HBsAg titers across multiple gradients,(ii)HBeAg seroconversion status(presence of HBeAb),and(iii)combined HBsAg/HBeAb patterns;inter-group differences in microbial community structure were then analyzed.Results:Across the six subgroups,β-diversity analyses revealed significant divergence in microbial community structure when patients were stratified by both HBsAg titre and HBeAb status(P<0.05).LEfSe profiling further identified subgroup-enriched taxa:Bacteroidetes dominated the low-HBsAg milieu,plausibly mirroring an immunovirological environment permissive to viral suppression.Akkermansia was selectively expanded in patients with low HBsAg and detectable HBeAb,implying a dual capacity to restrain HBV replication and foster serological conversion.Enrichment of Bifidobacterium and Megamonas was restricted to the low-HBsAg/HBeAb-negative niche,underscoring their putative role in suppressing viral replication without necessarily driving humoral seroconversion.Segatella,in contrast,was over-represented at both extremes of the HBsAg spectrum,suggesting its behaviour as a conditional pathobiont that may sustain immune homeostasis under controlled viraemia yet exacerbate inflammatory dysregulation when viraemia escalates.Conclusion:Gut microbiota signatures in CHB patients are tightly linked to quantitative HBsAg titres and HBeAb status,with specific taxa,most notably Bacteroidetes and Akkermansia,emerging as potential predictors of therapeutic response and actionable microbe-based targets.关键词
慢性乙型肝炎/肠道菌群/恩替卡韦/乙型肝炎病毒表面抗原/乙型肝炎病毒e抗体Key words
Chronic hepatitis B/gut microbiota/entecavir/HBsAg/HBeAb分类
医药卫生引用本文复制引用
胡淑颖,李小科,李金雨,张婷玉,张露丹,孙鑫,敖懿姿,杜宏波,叶永安,糟小宾..HBV不同感染状态的慢性乙型肝炎患者肠道菌群组成及差异研究[J].中西医结合肝病杂志,2025,35(10):1195-1203,9.基金项目
国家自然科学基金(No.82174341) （No.82174341）
