Coinfection: Helicobacter pylori/Human Immunodeficiency Virus

Abstract

To compare H. pylori infection prevalence and gastric mucosa damage in HIV-infected and non-HIV-infected patients, gastric biopsies were systematically taken in 209 individuals who underwent upper Gl endoscopy (102 HIV-infected and 107 non-HIV-infected). H. pylori was found in 42 (41.1%) HIV-infected patients and in 53 (49.5%) non-HIV patients (P = 0.22, chi2 = 1.47, NS). In HIV-positive patients infected with H. pylori the mean CD4 count was higher than in HIV-positive patients without H. pylori (364 and 228 cells/mm3, respectively; P = 0.0001). H. pylori gastritis was more severe in the HIV-positive group (chi2 = 15.02, P = 0.0001). The frequency of H. pylori in gastric mucosa in HIV-infected and non-HIV patients was similar. HIV-infected patients with H. pylori had a higher mean CD4 count than HIV-infected individuals without H. pylori. Gastric lesions associated with H. pylori were more severe in the HIV-positive population.

Helicobacter pylori infection in HIV-positive patients with digestive complaints

“…We did not find statistically significant associations between AIDS or C3 stage of HIV infection and the presence of Helicobacter pylori. However, there was a negative (OR=0.40), though not statistically significant association between CD4+ T-lymphocytes level < 200 cells/µL and Helicobacter pylori infection, which concurs to the tendency described in literature (2,5).…”

“…Lower prevalence of Helicobacter pylori infection was noticed at CD4+ T-lymphocyte levels below 200cells/µL (5). Other studies depicted a reduction in the frequency of Helicobacter pylori infection among severely immunosuppressed patients, with acquired immunodeficiency syndrome (AIDS) (2,3,5,(10)(11)(12)(13).…”

“…Several studies disputed over the prevalence of Helicobacter pylori infection among HIV-positive persons, reported to be either similar to (5,6) or lower than the prevalence of the same infection in the general population (2,7). Those depicting lower Helicobacter pylori infection rates among HIV-positive subjects incriminate the frequent use of antibiotics for opportunistic infections in severely immunocompromised patients, responsible for the accidental eradication of Helicobacter pylori (2).…”

A low prevalence ofH pyloriand endoscopic findings in HIV-positive Chinese patients with gastrointestinal symptoms

“…Reasons for these lower rates of H pylori infection remain unclear. Other studies showed that H pylori infection is similar in both HIV-positive and HIV-negative patients [12,13] . Patients infected with HIV, with or without acquired immune deficiency syndrome (AIDS), have a high incidence (50%-90%) of upper gastrointestinal symptoms [14] .…”

Systematic review: Heliocobacter pylori infection and impaired drug absorption

“…26,[39][40][41] As regards HIVpositive subjects, the prevalence of H. pylori infection seems not to be different from that in HIV-negative subjects, 36,42 but it has been observed that the histological score of H. pylori-gastritis was more severe in HIV-positive subjects. 43 Thus, the results of this review suggest that the impaired absorption of thyroxine, L-dopa and delavirdine associated with H. pylori infection may have potentially relevant clinical implications, because these drugs are often used in disorders in which the co-presence of H. pylori infection seems to be frequent and ⁄ or severe. A further finding which emerged from the present review was that one of the likely pathophysiological mechanisms for impaired drug absorption associated with H. pylori infection seems to be reduced gastric acid secretion.…”