Evidence map›Paper›PMID 41318835›Full record

ReviewNaunyn-Schmiedeberg's archives of pharmacology2026

The gut-liver-virus axis in hepatitis B and C: microbiota, immunometabolism, and exosome-mediated therapeutic opportunities.

Kainat Raziq, Syed Qaswar Ali Shah, Mirza Naveed Shahzad, Umm E Ummara, Mishal Subhan, Muhammad Muzammil Nazir

Abstract readReview
PubMed Publisher
In one paragraph

Review in Naunyn-Schmiedeberg's archives of pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Kainat RaziqDepartment of Zoology, Cholistan University of Veterinary and Animal Sciences, Bahawalpur, 63100, Pakistan. KainatRaziq123@gmail.com.
Syed Qaswar Ali ShahDepartment of Zoology, Cholistan University of Veterinary and Animal Sciences, Bahawalpur, 63100, Pakistan.
Mirza Naveed ShahzadDepartment of Statistics, University of Gujrat, Gujrat, 50700, Pakistan.
Umm E UmmaraDepartment of Zoology, Wildlife and Fisheries, University of Agriculture, Faisalabad, 38040, Pakistan.
Mishal SubhanDepartment of Microbiology and Molecular Genetics, The Women University Multan, Multan, 66000, Pakistan.
Muhammad Muzammil NazirDepartment of Zoology, Government College University, Faisalabad, 38000, Pakistan. muzammilnazir51@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections remain a major global health burden, leading to chronic liver disease, cirrhosis, and hepatocellular carcinoma (HCC). Despite advancements in vaccination and antiviral therapies, viral persistence, immune evasion, and disease progression continue to challenge global elimination goals. Recent evidence suggests that the gut-liver-virus axis, involving microbiota dysbiosis, immunometabolic reprogramming, and exosome mediated signaling, plays a central role in HBV and HCV related pathogenesis. A comprehensive literature search was conducted using PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar from January 2000 to August 2025. Studies were screened according to the PICO framework, focusing on HBV/HCV persistence, gut microbiota dysbiosis, immunometabolic changes, exosome-mediated communication, and therapeutic interventions. A total of 100 eligible studies, including clinical, preclinical, and mechanistic investigations, were synthesized. The analysis revealed that HBV and HCV infections remodel the gut liver axis through depletion of short-chain fatty acid (SCFA) producing taxa, enrichment of pro-inflammatory bacteria, and dysregulated bile acid and lipopolysaccharide metabolism. Viral persistence is sustained by immunometabolic rewiring, including glycolysis upregulation, lipid accumulation, and tryptophan kynurenine pathway activation, leading to T-cell exhaustion and immune suppression. Exosomes derived from infected hepatocytes and tumors facilitate viral spread, immune evasion, and oncogenesis while emerging as potential biomarkers and therapeutic nanocarriers. Collectively, these interconnected mechanisms drive inflammation, fibrosis, cirrhosis, and progression to HCC. The progression of HBV/HCV infections is governed by a complex interplay of viral persistence, gut microbiota alterations, metabolic reprogramming, and exosome-mediated communication. Targeting these pathways through microbiota-directed therapies, metabolic modulators, and exosome-based interventions offers promising opportunities for precision medicine. Future studies employing multi-omics integration, validated models, and longitudinal cohorts are required to establish causality and translate mechanistic insights into effective clinical strategies for preventing HBV/HCV associated cirrhosis and cancer.

Indexed as

ExosomesGastrointestinal MicrobiomeHepatitis BHepatitis CLiverAnimalsAntiviral AgentsDysbiosisHepacivirusHepatitis B virusHumansAntiviral AgentsBiomarkersCirrhosisExosomesGut–liver axisHepatitis B virusHepatitis C virusHepatocellular carcinomaImmunometabolismMicrobiota dysbiosisPrecision medicine

Identifiers

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.