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This review summarizes the relationship between hepatitis B virus and the microbiome as seen in published literature.

April 24, 2026Open Access

HBV and the Microbiome—PubMed Database Literature Review

Puntos clave

This review summarizes the relationship between hepatitis B virus and the microbiome as seen in published literature.
Conducted a literature review utilizing PubMed, identifying relevant publications on HBV and the microbiome.
Analyzed 110 studies from the 179 initially identified, excluding irrelevant or retracted papers.
Summarized findings related to microbiome alterations in HBV-infected individuals compared to healthy controls.
HBV-infected patients exhibited significant changes in their oral and fecal microbiome compared to healthy individuals.
Findings indicate that HBV infection leads to dysbiosis and reduced microbial diversity among patients.
Evidence suggests microbiome alterations may influence disease progression and liver-related metrics.

Resumen

Objective: Hepatitis B virus (HBV) is a globally distributed infectious disease affecting the liver. This literature review aims to summarize all available relevant information on the PubMed database about HBV’s connection to the microbiome and to consider possible treatment adjuncts. Materials and methods: Database used: PubMed. Keywords used: “HBV”, “Hepatitis B”, “microbiome”. In the PubMed database, 179 research publications were identified using these keywords; 69 studies were excluded as they were irrelevant or retracted. Of the remaining, 110 were analyzed in this literature review, and four additional literature sources were used to supply background information and context. Information was summarized. The analysed studies in total included 14,814 participants (excluding animal studies), of whom 8564 were HBV-infected individuals. Results: Results characterizing abundance or decrease in specific bacterial, viral, and fungal species are heterogeneous; multiple studies support that the HBV patient oral and fecal microbiome is different from that in healthy controls (HCs) and varies throughout disease progression. The HBV seems to transform the microbiome negatively, leading to dysbiosis and decreased microbial diversity in most studies. Evidence links HBV microbiome changes with influence on HbeAg seroconversion, HBV-DNA load, metabolic pathways, liver cirrhosis, and hepatocellular carcinoma. The research proposes that members of microbiota could potentially promote or protect against liver injury in HBV. Four studies proposed that the plasma virome in HBV patients was primarily composed of members of the Anelloviridae. One study researched a parasite (Entamoeba gingivalis) in HBV patients. Two studies analyzed HBV patients’ fungal profiles. Conclusions: Microbiota research, although promising, at the present moment is heterogeneous. HBV patients’ microbiota is distinguishable from HCs, and multiple studies have tried to identify the HBV characteristic microbiome; however, more precise information is needed to draw conclusions. Fecal microbiota transplantation and probiotics have the potential to be therapy adjuncts for HBV patients, but more research is needed.

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