Comparison of Demographic Characteristics and Upper Gastrointestinal Endoscopy Findings in HIV‐Positive, Antiretroviral‐Treated Patients With and Without <i>Helicobacter pylori</i> Coinfection

Nkuize, Marcel; Wit, Stéphane De; Muls, Vinciane; Ntounda, Ruffin; Gomez-Galdón, Maria; Buset, Michel

doi:10.1111/j.1523-5378.2011.00929.x

Cited by 11 publications

(10 citation statements)

References 28 publications

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“…In accordance with published data (Nkuize et al, 2010; Marano, Smith & Bonanno, 1993; Fialho et al, 2011; Chiu et al, 2004; Mohamed et al, 2002; Olmos et al, 2004; Nkuize et al, 2012), we also demonstrated the highest CD4 cell counts in HIV/ H. pylori co-infected patients. Moreover, CD4 cell counts show a positive increasing trend simultaneous with ART evolution from pre-HAART to modern HAART.…”

Section: Discussionsupporting

confidence: 93%

“…First, it is a retrospective case-control study. Second, various risk factors for H. pylori acquisition, such as exposure to antibiotics, as well as to proton-pump inhibitors (PPI) and H2 blocker therapies, along with hypochlorhydria, body mass index, particular habits, which have all been addressed by numerous studies before (Fialho et al, 2011; Chiu et al, 2004; Olmos et al, 2004; Nkuize et al, 2012), were not explored. Third, we have not sufficiently explored H. pylori acquisition in HIV negative cohorts.…”

Section: Discussionmentioning

confidence: 99%

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The increasing prevalence of HIV/Helicobacter pylori co-infection over time, along with the evolution of antiretroviral therapy (ART)

Spurnić

Brmbolic

Stojšić

et al. 2017

PeerJ

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Helicobacter pylori (H. pylori) is one of the most common human bacterial infections with prevalence rates between 10–80% depending upon geographical location, age and socioeconomic status. H. pylori is commonly found in patients complaining of dyspepsia and is a common cause of gastritis. During the course of their infection, people living with HIV (PLHIV) often have a variety of gastrointestinal symptoms including dyspepsia and while previous studies have reported HIV and H. pylori co-infection, there has been little data clarifying the factors influencing this. The aim of this case-control study was to document the prevalence of H. pylori co-infection within the HIV community as well as to describe endoscopic findings, gastritis topography and histology, along with patient demographic characteristics across three different periods of time during which antiretroviral therapy (ART) has evolved, from pre- highly active antiretroviral therapy (HAART) to early and modern HAART eras. These data were compared to well-matched HIV negative controls. Two hundred and twelve PLHIV were compared with 1,617 controls who underwent their first esophagogastroduodenoscopy (EGD) to investigate dyspepsia. The prevalence of H. pylori co-infection among PLHIV was significantly higher in the early (30.2%) and modern HAART period (34.4%) compared with those with coinfection from the pre-HAART period (18.2%). The higher rates seen in patients from the HAART eras were similar to those observed among HIV negative controls (38.5%). This prevalence increase among co-infected patients was in contrast to the fall in prevalence observed among controls, from 60.7% in the early period to 52.9% in the second observed period. The three PLHIV co-infected subgroups differed regarding gastritis topography, morphology and pathology. This study suggests that ART has an important impact on the endoscopic and histological features of gastritis among HIV/H. pylori co-infected individuals, raising the possibility that H. pylori-induced gastritis could be an immune restoration disease.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

The increasing prevalence of HIV/Helicobacter pylori co-infection over time, along with the evolution of antiretroviral therapy (ART)

Spurnić

Brmbolic

Stojšić

et al. 2017

PeerJ

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“…The prevalence of H . pylori infection among HIV-positive patients is variable, ranging from 10% to 76%, depending on the population studied and the geographic area [ 3 , 4 – 7 ]. In a recent study in our center, the prevalence of H .…”

Section: Introductionmentioning

confidence: 99%

“…In a recent study in our center, the prevalence of H . pylori co-infection was 48/145 (33%) among symptomatic HIV-positive patients who underwent UGI endoscopy, and was more common in patients of Black African origin and in heterosexuals [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

HIV-Helicobacter pylori Co-Infection: Antibiotic Resistance, Prevalence, and Risk Factors

et al. 2015

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BackgroundPatients infected with human immunodeficiency virus (HIV) are living longer due to the availability of more potent treatments. However, prescription of antibiotics to treat or prevent infections in these patients may increase the likelihood of co-infection with antibiotic-resistant species.AimTo compare antimicrobial susceptibility of Helicobacter pylori (H. pylori) in HIV-positive and HIV-negative patients and assess risk-factors for resistance.MethodsWe prospectively collected data from consecutive HIV-positive and HIV-negative patients undergoing upper gastrointestinal endoscopy. Patients with H. pylori-positive gastric biopsies who had never received H. pylori treatment were included.ResultsOf the 353 patients included, 93 were HIV-positive and 260 HIV-negative. Among the HIV-positive patients, 56 (60%) had been infected for <10 years, the median CD4+ count was 493 cells/μl and median viral load was 61 copies/mL; 66 (71%) were receiving antiretroviral therapy. HIV-positive patients were more often male (p = 0.009), had a lower body mass index (p<0.0001), and had less frequently received antibiotics during the 12-months prior to the endoscopy (p<0.0001) than HIV-negative patients. HIV-positive patients were more likely to have H. pylori resistant to levofloxacin (p = 0.0004), metronidazole (p = 0.01), or multiple antibiotics (p = 0.006). HIV-positive Black Africans were more likely to have resistant strains than were HIV-negative Black Africans (p = 0.04). Ethnicity and HIV status were independent risk factors for H. pylori resistance in all patients and acquired immune deficiency syndrome (AIDS) and sex were risk factors in HIV-positive patients.ConclusionsThere was a higher prevalence of primary H. pylori-resistant strains in HIV-positive than in HIV-negative patients. AIDS and sex were predictors of H. pylori resistance in HIV-positive patients.

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“…First, it is a retrospective case-control study. Second, various risk factors for H. pylori acquisition, such as exposure to antibiotics, as well as to proton-pump inhibitors (PPI) and H2 blocker therapies, along with hypochlorhydria, body mass index, particular habits, which have all been addressed by numerous studies before (12,13,25,26), were not explored. Third, we have not sufficiently explored H. pylori acquisition in HIV negative cohorts.…”

Section: Study Limitationsmentioning

confidence: 99%

Peer Review #1 of "The increasing prevalence of HIV/Helicobacter pylori co-infection over time, along with the evolution of antiretroviral therapy (ART) (v0.1)"

Palmer¹

2017

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Helicobacter pylori (H. pylori) is one of the most common human bacterial infections with prevalence rates between 10-80% depending upon geographical location, age and socioeconomic status. H. pylori is commonly found in patients complaining of dyspepsia and is a common cause of gastritis. During the course of their infection, people living with HIV (PLHIV) often have a variety of gastrointestinal symptoms including dyspepsia and while previous studies have reported HIV and H. pylori co-infection, there has been little data clarifying the factors influencing this. The aim of this case-control study was to document the prevalence of H. pylori co-infection within the HIV community as well as to describe endoscopic findings, gastritis topography and histology, along with patient demographic characteristics across three different periods of time during which antiretroviral therapy (ART) has evolved, from pre-highly active antiretroviral therapy (HAART) to early and modern HAART eras. These data were compared to well-matched HIV negative controls. Two hundred and twelve PLHIV were compared with 1617 controls who underwent their first esophagogastroduodenoscopy (EGD) to investigate dyspepsia. The prevalence of H. pylori co-infection among PLHIV was significantly higher in the early (30.2%) and modern HAART period (34.4%) compared with those with co-infection from the pre-HAART period (18.2%). The higher rates seen in patients from the HAART eras were similar to those observed among HIV negative controls (38.5%). This prevalence increase among co-infected patients was in contrast to the fall in prevalence observed among controls, from 60.7% in the early period, to 52.9% in the second observed period. The three PLHIV co-infected subgroups differed regarding gastritis topography, morphology and pathology. 3 This study suggests that ART has an important impact on endoscopic and histological features of gastritis among HIV/H. pylori co-infected individuals, raising the possibility that H. pylori-induced gastritis could be an immune restoration disease.

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Comparison of Demographic Characteristics and Upper Gastrointestinal Endoscopy Findings in HIV‐Positive, Antiretroviral‐Treated Patients With and Without Helicobacter pylori Coinfection

Abstract: In the antiretroviral therapy era, HIV-H. pylori coinfection is associated with a greater incidence of duodenal ulcers and higher CD4 counts, higher BMI, less comorbidity, and less frequent use of macrolides.

Cited by 11 publications

References 28 publications

The increasing prevalence of HIV/Helicobacter pylori co-infection over time, along with the evolution of antiretroviral therapy (ART)

The increasing prevalence of HIV/Helicobacter pylori co-infection over time, along with the evolution of antiretroviral therapy (ART)

HIV-Helicobacter pylori Co-Infection: Antibiotic Resistance, Prevalence, and Risk Factors

Peer Review #1 of "The increasing prevalence of HIV/Helicobacter pylori co-infection over time, along with the evolution of antiretroviral therapy (ART) (v0.1)"

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