DOI: http://dx.doi.org/10.18203/2349-3933.ijam20183912

Incidence and profile of Helicobacter pylori infection among HIV positive patients

Ramapriya Rengaswamy, Thayumanavan I.

Abstract


Background: People having HIV infection present with a number of symptoms related to gastrointestinal tract like dyspepsia. HIV itself as well as opportunistic infections is responsible for such symptoms. Notably is Helicobacter pylori infection causes variety of such symptoms. The objective of the present research was to study incidence and profile of Helicobacter pylori among HIV positive patients.

Methods: A hospital based cross sectional study was carried out over a period of two years among 101 HIV positive patients in the Department of General Medicine, Madurai Medical College, Madurai in collaboration with Department of Medical Gastroenterology and also Department of Venereology and Leporology. Rapid urease test was done. HIV status was confirmed by ELISA test. Data was analysed with the help of EPI statistical software.

Results: Majority (40.6%) had CD4 count of 200-500. It has been observed that incidence of Helicobacter pylori was low in groups with low CD4 count. It was also observed that those with higher CD4 count had higher incidence of RUT positivity. This association was found to be statistically significant. The incidence of Helicobacter pylori positivity was not significantly different among those patients who were on ART (18%) and those who were not on ART (21%).

Conclusions: The incidence of Helicobacter pylori infection was less in HIV positive patients. Those with CD4 cell count less than 100 had lower incidence of Helicobacter pylori infection than those with CD 4 cell count more than 500. Incidence of Helicobacter pylori infection was not affected by ART.

Keywords


CD4 count, HIV positive, Rapid urease test

Full Text:

PDF

References


UNAIDS Fact sheet, people living with HIV, HIV, antiretroviral therapy, new HIV infection, AIDS, tuberculosis, facts. 2016 Fact sheet November 2016. Available at http://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf Accessed on: 5-8-2017.

Serlin and Dieterich. Serlin MH, Dieterich D. Global HIV/AIDS medicine. Elsevier; 2008. Chapter 23. Gastrointestinal disorders in HIV. 2008; 251-260.

Brown LM. Helicobacter pylori: epidemiology and routes of transmission. Epidemiol Rev. 2000; 22(2):283-97.

Marano BJ Jr, Smith F, Bonanno CA. Helicobacter pylori prevalence in acquired immunodeficiency syndrome. Am J Gastroenterol. 1993 May; 88(5):687-90.

AliMohamed F, Lule GN, Nyong'o A, Bwayo J, Rana FS. Prevalence of Helicobacter pylori and endoscopic findings in HIV seropositive patients with upper gastrointestinal tract symptoms at Kenyatta National Hospital, Nairobi. East Afr Med J. 2002 May; 79(5):226-31.

Assimakopoulos SF, Dimitropoulou D, Marangos M, Gogos CA. Intestinal barrier dysfunction in HIV infection: pathophysiology, clinical implications and potential therapies. Infection. 2014 Dec; 42(6):951-9.

Khamri W, Walker MM, Clark P, Atherton JC, Thursz MR, Bamford KB, et al. Helicobacter pylori stimulates dendritic cells to induce interleukin-17 expression from CD4+ T lymphocytes. Infect Immun. 2010 Feb; 78(2):845-53.

Carrick J, Lee A, Hazell S, Ralston M, Daskalopoulos G. Campylobacter pylori duodenal ulcer and gastric metaplasia: possible role of functional heterotopic tissue in ulcerogenesis. Gut. 1989;30:790-7.

Suzuki H, Hibi T, Marshall BJ. Helicobacter pylori: present status and future prospects in Japan. J Gastroenterol. 2007;42:1-15.

Battan R, Raviglione MC, Palagiono A, Boyle JF, Sabatini MT, Sayad K et al. Helicobacter pylori infection in patients with Acquired Immuno Deficiency Syndrome. Am J Gastroenterol. 1990;85(9120):1576-9.

Ali Mohammed F, Lule GN, Nyong OA, Bwayo J, Rana FS. Prevalence of Helicobacter pylori and endoscopic findings in HIV seropositive patients with upper GI symptoms at Kenyatta National Hospital, Nairobi. East Afr Med J. 2002;79(5):226-31.

Lv Fj, Luo XL, Meng X, Jin R, Ding HG, Zhang ST. A low prevalence of Helicobacter pylori and endoscopic findings in HIV positive Chinese patients with gastrointestinal symptoms. World J Gastroenterol. 2007;13(14):5492-6.

Edwards FD, Carrick J, Turner J, Lee a, Mitchell H, Cooper DA. Helicobacter pylori associated gastritis is rare in AIDS: antibiotic effect or a consequence of immunodeficiency? Am J Gastroenterol. 1991;86(12):1761-4.

Skwara P, Mach T, Tomaszewska R, Sobczyk-krupiarz I, Ciesla A. Studies on relationship between immunodeficiency in HIV infected people and condition of upper gastrointestinal tract mucosa, prevalence of mycosis and Helicobacter pylori infection. Przegl Lek. 2005;62:1401-4.

Mach T, Skwara P, Biesiada G, Ciesla A, Macura A. Morphological changes of the upper gastrointestinal tract mucosa and Helicobacter pylori infection in HIV positive patients with severe immunodeficiency and symptoms of dyspepsia. Med Sci Monit. 2007;13(1):14-9.