Gut microbiota dysbiosis associated with plasma levels of Interferon‐γ and viral load in patients with acute hepatitis E infection

Few studies have focused on the effect of hepatitis E virus (HEV) infection on gut microbiota. To explore the relationship between changes in gut microbiota and inflammatory factors and viral load, we conducted a comparative study of 33 patients with acute hepatitis E (AHE) patients and 25 healthy controls (HCs) using high‐throughput 16S ribosomal ribonucleic acid gene sequencing. Shannon and Simpson's indices showed no significant differences in bacterial diversity between the AHE and HCs groups. Proteobacteria, Gammaproteobacteria, and Enterobacteriaceae were most abundant in the AHE group, which contributed to the difference between the gut microbiota of the AHE and HCs groups, and the same difference between the HEV‐RNA‐positive and HEV‐RNA‐negative groups. Functional prediction analysis showed that ribosome, purine metabolism, and two‐component system were the top three pathways. Compared with the AHE group with normal interferon (IFN)‐γ, Proteobacteria, Gammaproteobacteria, Xanthomonadaceae, and Enterobacteriaceae were more abundant in the high‐IFN‐γ group. The abundance of Gammaproteobacteria was positively correlated with the level of serum alanine transaminase and total bilirubin. The abundance of Gammaproteobacteria could discriminate AHE patients from HCs, and could better predict the severity of AHE patients. We believe that our findings will contribute toward a novel treatment strategy for AHE. HIGHLIGHTS Dysbiosis of the gut microbiota is associated with hepatitis E virus infection, plasma levels of interferon‐γ, and viral load in acute hepatitis E (AHE) patients. Abundance of Gammaproteobacteria could discriminate AHE patients from healthy controls. Functional prediction analysis showed that ribosome, purine metabolism, and two‐component system were the top three pathways. Abundance of Gammaproteobacteria could better predict the severity of AHE patients.