Fig. 6

Suggested gut-liver axis model for chronic HCV infection. HCV starts to invade hepatocytes with massive destruction of the hepatocyte architecture and structure (1), which leads to their loss of functions, such as bile salt production and protein synthesis (2). Consequently, such damage leads to disruption of the gut homeostasis and environmental changes (3), which can affect and change the microbiota abundance and composition (possible dysbiosis, 4). The overabundance of microbes, such as Prevotella, may produce signaling microbial metabolites that may influence and initiate the inflammatory mediators leading to liver inflammation and cirrhosis (5). This model is based on an integration of the findings of this study with literature [19, 20, 35–38, 42, 43, 45]