Increasing evidence demonstrate that the gut microbiota is involved in the pathogenesis of liver diseases, and faecal microbiota transplantation is considered to be a promising new treatment option. However, there are no reports on the intestinal flora of asymptomatic HBV carriers using next-generation sequencing. This study intends to investigate the potential role of the intestinal microflora in predicting the progression of Hepatitis B patients in different non-cancerous stages. A total of 266 patients with different stages of Hepatitis B and 31 healthy controls were included in this study. Some of the subjects (217 cases) underwent 16S rRNA gene sequencing. Compared with the control group (CK), the α diversity of patients in Group A (HBV carrier) slightly increased, while that of patients in the other three groups decreased. Each group of patients, especially those in Group C (cirrhosis) and Group D (acute-on-chronic liver failure), could be separated from the CK using weighted UniFrac PCoA and ANOSIM. LEfSe revealed that 40 taxa belonging to three phyla had an LDA larger than 4. In addition to the comparison between Group B (chronic Hepatitis B) and Group C, the specific flora and potential taxonomic function were also identified. Different microbial communities were found to be highly correlated with clinical indicators and the Child-Pugh scores. Changes in the microbial community were highly related to the alternations of host metabolism, which in turn, was related to the development of Hepatitis B. Our analysis identified a total of 47 strains with potential biomarker functions at all levels except for the phylum level. Faecal microbiota transplantation of some potential beneficial bacteria can change with the occurrence of disease, and HBV carriers might be the most suitable donors.

中文翻译：

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肠道菌群在不同阶段乙型肝炎患者疾病进展中的潜在作用

越来越多的证据表明肠道微生物群参与肝脏疾病的发病机制，粪便微生物群移植被认为是一种有前途的新治疗选择。然而，目前还没有利用二代测序技术对无症状乙型肝炎病毒携带者的肠道菌群进行研究的报道。本研究旨在探讨肠道微生物群在预测乙型肝炎患者不同非癌阶段进展中的潜在作用。本研究共纳入266名不同阶段的乙型肝炎患者和31名健康对照者。部分受试者（217例）接受了16S rRNA基因测序。与对照组（CK）相比，A组（HBV携带者）患者的α多样性略有增加，而其他三组患者的α多样性则有所下降。每组患者，尤其是 C 组（肝硬化）和 D 组（慢性肝衰竭急性发作）的患者，可以使用加权 UniFrac PCoA 和 ANOSIM 从 CK 中分离出来。LEfSe揭示了属于3个门的40个分类群的LDA大于4。除了B组（慢性乙型肝炎）和C组之间的比较之外，还确定了特定菌群和潜在的分类功能。研究发现不同的微生物群落与临床指标和 Child-Pugh 评分高度相关。微生物群落的变化与宿主代谢的变化高度相关，而宿主代谢的变化又与乙型肝炎的发生有关。我们的分析共鉴定出47个菌株，在除门水平外的所有水平上都具有潜在的生物标志物功能。粪便微生物群移植中一些潜在的有益菌会随着疾病的发生而发生变化，而乙型肝炎病毒携带者可能是最合适的供体。