Association Between Helicobacter pylori Infection and Cirrhosis in Patients with Chronic Hepatitis C Virus

We evaluated, employing a logistic regression model, the association between Helicobacter pylori infection and cirrhosis in a cohort of 106 patients (57 males; mean age, 52.9 years; range, 20–78 years) with chronic hepatitis C virus (HCV) from Rosario, Argentina. HCV was confirmed by ELISA and PCR. H. pylori status was determined by ELISA. Of the 106 patients evaluated, 47 (44.3%) had cirrhosis. A total of 70.2% (33/47) of cirrhotic patients and 47.5% (28/59) of noncirrhotic patients were H. pylori-positive. In univariate analyses, cirrhosis was associated with age (P = 0.016) and H. pylori-positive status (P = 0.019) but not with gender (P = 0.28) or length of infection (P = 0.35). In multivariate analysis, H. pylori infection (P = 0.037; OR = 2.42; 95% CI = 1.06–5.53) and age (P = 0.033; OR = 1.04; 95% CI = 1.00–1.07) of patients remained significant and independently associated with cirrhosis. In conclusion, our results demonstrate an association between H. pylori infection and cirrhosis in patients with hepatitis C virus.

[1]  L. Roncucci,et al.  Frequency of upper gastrointestinal lesions in patients with liver cirrhosis , 1988, Digestive Diseases and Sciences.

[2]  P. Bedossa,et al.  Natural history of liver fibrosis progression in patients with chronic hepatitis C , 1997, The Lancet.

[3]  J. Gavaler,et al.  Prevalence of endoscopic findings in 510 consecutive individuals with cirrhosis evaluated prospectively , 1990, Digestive Diseases and Sciences.

[4]  S. V. van Deventer,et al.  Mucosal tumor necrosis factor-alpha, interleukin-1 beta, and interleukin-8 production in patients with Helicobacter pylori infection. , 1994, Scandinavian journal of gastroenterology.

[5]  David B. Schauer,et al.  Emergence of Diverse HelicobacterSpecies in the Pathogenesis of Gastric and Enterohepatic Diseases , 2001, Clinical Microbiology Reviews.

[6]  L. Bolondi,et al.  High Prevalence of Helicobacter pylori in Liver Cirrhosis (Relationship with Clinical and Endoscopic Features and the Risk of Peptic Ulcer) , 1997, Digestive Diseases and Sciences.

[7]  J. Broadhead,et al.  WHO consensus statement. , 1990, The British journal of psychiatry : the journal of mental science.

[8]  G. Corrao,et al.  Independent and combined action of hepatitis C virus infection and alcohol consumption on the risk of symptomatic liver cirrhosis. , 1998, Hepatology.

[9]  G. Tytgat.  Endoscopic transmission of Helicobacter pylori. , 1995, Alimentary pharmacology & therapeutics.

[10]  J. Pawlotsky,et al.  Epidemiological factors affecting the severity of hepatitis C virus‐related liver disease: A French survey of 6,664 patients , 1997, Hepatology.

[11]  M. Fiorentino,et al.  Helicobacter pylori seroprevalence in hepatitis C virus positive patients with cirrhosis. , 2000, Journal of hepatology.

[12]  H. Ríos,et al.  Prevalence of Helicobacter pylori infection in Argentina: results of a nationwide epidemiologic study. , 2000 .

[13]  A. Varela,et al.  [Seroprevalence of helicobacter pylori infection in the republic of Argentina: influence of age, sex, socioeconomic level, geographical area, and health infrastructure. Multicenter study by the Club Argentino del Estomago y Duodeno]. , 1999, Acta gastroenterologica Latinoamericana.

[14]  J. Crabtree,et al.  Mucosal tumour necrosis factor alpha and interleukin-6 in patients with Helicobacter pylori associated gastritis. , 1991, Gut.

[15]  A. Burroughs,et al.  Peptic ulcer and its course in cirrhosis: an endoscopic and clinical prospective study. , 1995, Journal of hepatology.

[16]  G. R. Davies,et al.  Relationship between infective load of Helicobacter pylori and reactive oxygen metabolite production in antral mucosa. , 1994, Scandinavian journal of gastroenterology.

[17]  U. Stenram,et al.  Helicobacter species identified in liver from patients with cholangiocarcinoma and hepatocellular carcinoma. , 2001, Gastroenterology.

[18]  T. Macdonald,et al.  Interferon gamma and interleukin 4 secreting cells in the gastric antrum in Helicobacter pylori positive and negative gastritis. , 1995, Gut.

[19]  L. Silengo,et al.  Helicobacter infection and cirrhosis in hepatitis C virus carriage: is it an innocent bystander or a troublemaker? , 2000, Medical hypotheses.

[20]  R. Purcell,et al.  Interrelationship of blood transfusion, non‐A, non‐B hepatitis and hepatocellular carcinoma: Analysis by detection of antibody to hepatitis C virus , 1990, Hepatology.

[21]  J. Fox,et al.  Hepatobiliary Helicobacters: recognized animal pathogens with suspected pathogenic potential in humans , 2000 .

[22]  E. Rauws,et al.  Patient-to-patient transmission of Campylobacter pylori infection by fiberoptic gastroduodenoscopy and biopsy. , 1990, The Journal of infectious diseases.

[23]  W. Atoyebi,et al.  Rapid eradication of Helicobacter pylori infection , 1995, Alimentary pharmacology & therapeutics.

[24]  M. Alter,et al.  Epidemiology of Hepatitis C in the West , 1995, Seminars in liver disease.

[25]  J. Taneera,et al.  Identification of Helicobacter pylori and OtherHelicobacter Species by PCR, Hybridization, and Partial DNA Sequencing in Human Liver Samples from Patients with Primary Sclerosing Cholangitis or Primary Biliary Cirrhosis , 2000, Journal of Clinical Microbiology.

[26]  F. Mégraud,et al.  Helicobacter pylori and duodenal ulcer , 1992, Digestive Diseases and Sciences.

[27]  Y. Liaw,et al.  Detection and partial sequence analysis ofHelicobacter pylori DNA in the bile samples , 1995, Digestive Diseases and Sciences.

[28]  D M de Magalhães Queiroz,et al.  Isolation of a Helicobacter strain from the human liver. , 2001, Gastroenterology.

[29]  H. Blum,et al.  Long-term follow-up of posttransfusion and sporadic chronic hepatitis non-A, non-B and frequency of circulating antibodies to hepatitis C virus (HCV). , 1990, Journal of hepatology.

[30]  E. Mendes,et al.  Serodiagnosis of Helicobacter pylori infection by Cobas Core ELISA in adults from Minas Gerais, Brazil. , 1998, Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas.

[31]  F. Mégraud,et al.  Detection of Helicobacter species in the liver of patients with and without primary liver carcinoma , 2000, Cancer.

[32]  Willis C. Maddrey,et al.  EASL International Consensus Conference on hepatitis C. Paris, 26-27 February 1999. Consensus statement. , 1999, Journal of hepatology.

[33]  M. Tong,et al.  Clinical outcomes after transfusion-associated hepatitis C. , 1995, The New England journal of medicine.