Prevalence and Risk Factors of Helicobacter Pylori Recurrence in Egyptian Patients with Liver Cirrhosis | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 25, Volume 84, Issue 1, July 2021, Pages 1791-1794 PDF (537.18 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2021.177254 | ||
| Authors | ||
| Mohamed G. Hamed1; Mohamed Bassiony2; Ayman F. Elsayed Mohamed3 | ||
| 1Internal Medicine Department, Faculty of Medicine, Zagazig University,Egy | ||
| 2Internal medicine department, Faculty of medicine, Zagazig university, Zagazig, Egypt | ||
| 3Internal Medicine Department, Faculty of Medicine, Zagazig University,Egypt | ||
| Abstract | ||
| Background: Helicobacter pylori (H. pylori) is a worldwide gastrointestinal infection. It is a common risk factor for peptic ulcer disease (PUD), chronic gastritis, and stomach cancer. In patients with cirrhosis, there is a significant association between H. pylori infection and severity of gastropathy due to portal hypertension, chronic stomach upset, frequent upper gastrointestinal bleeding as well as hepatic encephalopathy. Objective: To assess the rate and risk factors of recurrence of H. pylori infection in Egyptian patients with liver cirrhosis after successful eradication therapy. Patients and methods: This study included 500 liver cirrhosis patients who were tested for H. pylori infection. Patients with positive H. pylori infection received proton pump inhibitors (PPI)-based treatment regimen. Successful eradication therapy was assessed 4-8 weeks and repeated over one year after end of treatment using urea breath test (UBT) and stool antigen test (SAT). Results: The prevalence of H. pylori infection in cirrhotic patients was 58%. There were significantly higher serum levels of ammonia and C-reactive protein (CRP) in H. pylori positive patients as well as significantly more gastritis in endoscopy findings in comparison with H. pylori-negative patients. H. pylori recurrence after successful eradication therapy was observed in 22.1% patients of H. pylori-positive cirrhotic patients. Multivariate analysis showed that higher serum ammonia level & receiving multiple treatment courses to achieve H. pylori eradication were independent risk factors for H. pylori recurrence in cirrhotic patients. Conclusion: H. pylori infection is prevalent in liver cirrhosis patients with a significant recurrence rate after eradication therapy. High serum ammonia and the need for multiple treatment courses are risk factors for recurrence. | ||
| Keywords | ||
| Helicobacter pylori; Liver cirrhosis; Eradication therapy; Hepatitis C; Ammonia level; Bacterial resistance | ||
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