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Helicobacter pylori infection among patients with liver cirrhosis
Joanna Pogorzelska1, Magda Łapińska, Alicja Kalinowska
1Departments of aInfectious Diseases and Hepatology bPopulation Medicine and Civilization Diseases Prevention, Medical University of Bialystok, Bialystok, Poland.
Insights
Helicobacter pylori infection is more common in patients with liver cirrhosis due to hepatitis C or B viruses than alcoholic cirrhosis. This infection correlates with higher blood ammonia and esophageal varices in cirrhosis patients.
Area of Science:
- Hepatology and Gastroenterology
- Microbiology
- Clinical Medicine
Background:
- Helicobacter pylori (H. pylori) infection can impact liver function and potentially exacerbate liver cirrhosis.
- The prevalence and implications of H. pylori in liver cirrhosis patients require further investigation.
Purpose of the Study:
- To determine the incidence of H. pylori infection in liver cirrhosis patients.
- To analyze H. pylori prevalence based on cirrhosis etiology and severity (Child-Pugh classification).
- To assess the relationship between H. pylori infection, esophageal varices, and gastric inflammatory lesions.
Main Methods:
- A cohort of 147 liver cirrhosis patients was studied, categorized by etiology: hepatitis C virus (HCV), hepatitis B virus (HBV), alcoholic, and primary biliary cirrhosis.
- H. pylori infection was diagnosed via serum immunoglobulin G antibody detection.
- Patients were evaluated for esophageal varices and endoscopic gastric lesions.
Main Results:
- H. pylori infection was detected in 46.9% of the studied liver cirrhosis patients.
- A significantly higher incidence of H. pylori was observed in postinflammatory liver cirrhosis (HCV/HBV) compared to alcoholic liver cirrhosis (P=0.001).
- H. pylori-infected patients showed significantly higher blood ammonia levels (129 vs. 112 μmol/l; P=0.002) and a higher prevalence of esophageal varices (60% vs. 14%; P<0.001).
Conclusions:
- H. pylori infection is more prevalent in liver cirrhosis associated with viral hepatitis (postinflammatory) than in alcoholic or primary biliary cirrhosis.
- H. pylori infection is significantly associated with elevated blood ammonia levels and the presence of esophageal varices in liver cirrhosis patients.
Background And Aim:
Inflammatory changes in the stomach caused by Helicobacter pylori indirectly and directly affect liver function. Moreover, the bacteria may worsen the course of the liver cirrhosis. The study aimed at evaluating the incidence of H. pylori infection among patients with liver cirrhosis, depending on the etiology and injury stage, scored according to Child-Pugh classification. Stage of esophageal varices and endoscopic inflammatory lesions in the stomach were evaluated, depending on the presence of H. pylori infection.
Patients And Methods:
The study included 147 patients with liver cirrhosis: 42 were infected with hepatitis C virus, 31 were infected with hepatitis B virus, 56 had alcoholic liver cirrhosis, and 18 had primary biliary cirrhosis. Diagnosis of H. pylori infection was performed based on the presence of immunoglobulin G antibodies in serum.
Results:
H. pylori infection was found in 46.9% of patients. The incidence of H. pylori infection among patients with postinflammatory liver cirrhosis was significantly higher (P=0.001), as compared with patients with alcoholic liver cirrhosis. Ammonia concentration was significantly higher in patients infected with H. pylori, compared with noninfected individuals (129 vs. 112 μmol/l; P=0.002). Incidence of H. pylori infection in patients without esophageal varices was significantly lower compared with patients with esophageal varices (14 vs. 60%; P<0.001).
Conclusion:
H. pylori infection is significantly more frequent among patients with postinflammatory liver cirrhosis (infected with hepatitis C virus or hepatitis B virus) than in patients with alcoholic liver cirrhosis or primary biliary cirrhosis. H. pylori infection correlates with elevated concentration of blood ammonia and the incidence of esophageal varices.
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