Association of Helicobacter Pylori infection with Liver cirrhosis among Patients Presenting in a Tertiary Care Hospital of Lahore, Pakistan

Authors

  • Mahboob Ahmad King Edward Medical University ,Mayo Hospital, Lahore
  • Sami Ullah Mumtaz King Edward Medical University,Mayo Hospital,Lahore
  • Samara Siddique King Edward Medical University ,Mayo Hospital, Lahore
  • Tooba Fatima King Edward Medical University ,Mayo Hospital, Lahore
  • Asif Islam King Edward Medical University ,Mayo Hospital, Lahore
  • Waqar Ali King Edward Medical University ,Mayo Hospital, Lahore

DOI:

https://doi.org/10.51273/esc23.251319417

Keywords:

Helicobacter Pylori Infection, Liver Cirrhosis, Association, Stool antigen

Abstract

Objective: To determine the association of H. pylori infection with liver cirrhosis among patients presenting in a tertiary care hospital of Lahore, Pakistan.
Material and Methods: This case control study was conducted at Medicine wards, Mayo Hospital, Lahore for six months.130 patients including 65 cases of liver cirrhosis (ultrasonography proven) and 65 healthy volunteers as controls were taken through non-probability consecutive sampling technique. A stool sample for Helicobacter Pylori antigen detection was taken from both cases and controls following standard sterile collection procedure. Samples were then submitted to the pathology laboratory. H. pylori antigen results were noted in a predesigned proforma. Data was analyzed using SPSS 24.0.Then the association of helicobacter pylori with liver cirrhosis was recorded by calculating taking odds ratio and taking it >1 as statistically significant.
Results: The minimum age recorded in our study was 20 years and maximum age noted was 70 years. Mean age + standard deviation were 44.32 ± 13.72 years. We had 66 (50.8%) male and 64(49.2%) female patients. Out of 65 cases, helicobacter pylori infection was found in 48(73.85%) while in 65 controls, helicobacter pylori infection was found in 29(44.62%) patients. Presence of helicobacter pylori was significantly associated with liver cirrhosis as odds ratio=3.51 and p-value = 0.001.
Conclusion: Helicobacter pylori infection was significantly associated with liver cirrhosis. Hence early diagnosis and treatment may decrease the complications.

Author Biographies

Mahboob Ahmad, King Edward Medical University ,Mayo Hospital, Lahore

Medial Officer

Sami Ullah Mumtaz, King Edward Medical University,Mayo Hospital,Lahore

Assistant professor medicine

Samara Siddique, King Edward Medical University ,Mayo Hospital, Lahore

Assstant Professor Medicine

Tooba Fatima, King Edward Medical University ,Mayo Hospital, Lahore

Senior Registrar

Asif Islam, King Edward Medical University ,Mayo Hospital, Lahore

Senior Registrar

Waqar Ali, King Edward Medical University ,Mayo Hospital, Lahore

Senior Registrar

References

Mitchell H, Katelaris P. Epidemiology, clinical impacts and current clinical management of Helicobacter pylori infection. Med J Aust 2016; 10:376–380.

Sustmann A, Okuda M, Koletzko S. Helicobacter pylori in children. Helicobacter 2016; 21: 49-54.

Tapper EB, Parikh ND. Diagnosis and Management of Cirrhosis and Its Complications: A Review. JAMA. 2023;329(18):1589–1602.

Hooi J.K.Y., Lai W.Y., Ng W.K., Suen M.M.Y., Underwood F.E., Tanyingoh D., Malfertheiner P., Graham D.Y., Wong V.W.S., Wu J.C.Y., et al. Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis. Gastroenterology. 2017;153:420–429.

World Gastroenterology O. World Gastroenterology Organisation Global Guideline: Helicobacter pylori in developing countries. J. Clin. Gastroenterol. 2011;45:383–388.

Burucoa C., Axon A. Epidemiology of Helicobacter pylori infection. Helicobacter. 2017;22(Suppl. 1).

32. Hunt R.H., Xiao S.D., Megraud F., Leon-Barua R., Bazzoli F., van der Merwe S., Vaz Coelho L.G., Fock M., Fedail S., Cohen H., et al. Helicobacter pylori in developing countries. World Gastroenterology Organisation Global Guideline. J. Gastrointest. Liver Dis. 2011;20:299–304.

Xia HX, Windle HJ, Marshall DG, Smyth CJ, Keane CT, O’Morain CA. Recrudescence of Helicobacter pylori after apparently successful eradication: novel application of randomly amplified polymorphic DNA fingerprinting. Gut [Internet]. 1995;37(1):30–4.

Singh V, Mishra S, Rao GRK, Jain AK, Dixit VK, Gulati AK, et al. Evaluation of nested PCR in detection of Helicobacter pylori targeting a highly conserved gene: HSP60: Nested PCR in detection of H. pylori. Helicobacter [Internet]. 2008;13(1):30–4.

Zullo A,Romilli A,Rinaldi V,Vecchione A.Gastric epithelial cell proliferation in patients with liver cirrhosis.Dig Dis Sci 2001;46(3):550-4.

Waluga M,Kukla M,Zorniak M,Bacik A,Kotulski R.From the stomach to other organs:Helicobacter pylori and the liver.World J Hepatol.(2015)7:2136-46.

Sun X, Xu Y, Wang L, Zhang F, Zhang J, Fu X, et al. Association between TNFA gene polymorphisms and Helicobacter pylori infection: a meta-analysis. PLoS One 2016; 1:e0147410.

Silva LD, Rocha AM, Rocha GA, de Moura SB, Rocha MM, Dani R, et al. The presence of Helicobacter pylori in the liver depends on the Th1, Th17 and Treg cytokine profile of the patient. Mem Inst Oswaldo Cruz 2011; 106:748–754.

Buzás GM. Metabolic consequences of Helicobacter pylori infection and eradication. World J Gastroenterol 2014; 18:5226–5234.

Abdel-Razik A, Mousa N, Shabana W, Refaey M, Elhelaly R, Elzehery R, et al. Helicobacter pylori and non-alcoholic fatty liver disease: a new enigma? Helicobacter. (2018) 23:e12537.

Queiroz DM, Rocha AM, Rocha GA, Cinque SM, Oliveira AG, Godoy A, Tanno H. Association between Helicobacter pylori infection and cirrhosis in patients with chronic hepatitis C virus. Dig Dis Sci. 2006 Feb;51(2):370-3.

Feng H, Zhou X, Zhang G. Association between cirrhosis and Helicobacter pylori infection: a meta-analysis. Eur J Gastroenterol Hepatol. 2014 Dec;26(12):1309-19.

Pogorzelska J, Łapińska M, Kalinowska A, Łapiński TW, Flisiak R. Helicobacter pylori infection among patients with liver cirrhosis. Eur J Gastroenterol Hepatol. 2017 Oct; 29(10):1161-1165.

Singh MP, Yadav KA, Singh B, Gautam A. Prevalance of H. Pylori Infection in Patients of Cirrhosis of Liver with Its Etiological Correlation. 2022 Feb; 10(02):60-7.

Xu G, Ma S, Dong L, Mendez-Sanchez N, Li H, Qi X. Relationship of Helicobacter pylori Infection with Nonalcoholic Fatty Liver Disease: A Meta-Analysis. Can J Gastroenterol Hepatol. 2023 Jan; 2023: 5521239.

Ahmed S, Siddiqui A, Iqbal S, Waqas R, Ara J, Kidwai AA. Frequency of H. pylori in liver cirrhosis patients with overt Hepatic encephalopathy at tertiary care hospital, Karachi. IJEHSR [Internet].2022 Jul; 10 (3):343-8.

Mohamed A, Mohamed M, Kamel H, Aziz W. “Helicobacter pylori infection in HCV related liver cirrhotic patients; prevalence and association with upper gastrointestinal bleeding.” Minia Journal of Medical Research [Internet]. 2020 [cited 2023 Jul 29];31(1):284–9.

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Published

2024-02-03

How to Cite

1.
Ahmad M, Mumtaz SU, Siddique S, Fatima T, Islam A, Ali W. Association of Helicobacter Pylori infection with Liver cirrhosis among Patients Presenting in a Tertiary Care Hospital of Lahore, Pakistan. Esculapio - JSIMS [Internet]. 2024 Feb. 3 [cited 2024 Dec. 21];19(04):457-60. Available from: https://esculapio.pk/journal/index.php/journal-files/article/view/651

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