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Hanafy AS, El Hawary AT, Hamed EF, Hassaneen AM. Impact of Helicobacter pylori eradication on refractory thrombocytopenia in patients with chronic HCV awaiting antiviral therapy. Eur J Clin Microbiol Infect Dis 2016; 35:1171-6. [PMID: 27180243 DOI: 10.1007/s10096-016-2650-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 04/14/2016] [Indexed: 01/06/2023]
Abstract
The possibility of delaying treatment of HCV due to severe thrombocytopenia is challenging. This study aimed to detect the prevalence of active helicobacter infection as a claimed cause of thrombocytopenia in a cohort of Egyptian patients with chronic active HCV awaiting combined anti-viral therapy. The study included 400 chronic HCV patients with thrombocytopenia. Laboratory investigations included liver function tests, real time quantitative PCR, reticulocytic count, ESR, ANA, bone marrow aspiration, measurement of anti-helicobacter antibodies, and helicobacter stool antigen. Positive cases for active H. pylori were given the standard triple therapy for 2 weeks. Helicobacter stool antigen was detected 4 weeks after termination of therapy and the change in platelet count was detected 1 month after eradication. A total of 248 out of 281 seropositive patients for H. pylori (88.3 %) showed positive stool antigen (p = 0.01). Eradication was achieved in 169 (68.1 %) patients with platelet mean count 114.9 ± 18.8 × 10(3)/μl with highly significant statistical difference from pretreatment value (49.7 ± 9.2 × 10(3)/μl, p = 0.000). Seventy-nine patients were resistant to conventional triple therapy and given a 7-day course of moxifloxacin-based therapy; 61 patients responded (77.1 %) with mean platelet improvement from 76.4 ± 17.4 × 10(3)/μl to 104.2 ± 15.2 × 10(3)/μl (p = 0.000). The non-responders showed no improvement in their platelet count (74.6 ± 20.5 vs. 73.6 ± 15.3 × 10(3)/ul, P = 0.5). Eradication of active H. pylori in HCV augments platelet count and enhances the early start of antiviral therapy.
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Affiliation(s)
- A S Hanafy
- Internal Medicine Department, Hepatogastroenterology Division, Zagazig University, Zagazig, Egypt.
| | - A T El Hawary
- Internal Medicine Department, Hepatogastroenterology Division, Zagazig University, Zagazig, Egypt
| | - E F Hamed
- Internal Medicine Department, Hepatogastroenterology Division, Zagazig University, Zagazig, Egypt
| | - A M Hassaneen
- Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.,Clinical Pathology Department, Faculty of Medicine, Sulaiman AlRajhi Colleges, Al Bukayriyah, Saudi Arabia
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The Association between Helicobacter pylori Infection and Chronic Hepatitis C: A Meta-Analysis and Trial Sequential Analysis. Gastroenterol Res Pract 2016; 2016:8780695. [PMID: 26904112 PMCID: PMC4745339 DOI: 10.1155/2016/8780695] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 11/16/2015] [Indexed: 01/30/2023] Open
Abstract
Purpose. Helicobacter pylori is a common gastric disease-inducing pathogen. Although an increasing number of recent studies have shown that H. pylori is a risk factor for liver disease, the potential association between H. pylori infection and chronic hepatitis C still remains controversial. The aim of our meta-analysis was to evaluate a potential association between H. pylori infection and chronic hepatitis C. Methods. We searched the PubMed, Embase, CNKI, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases between January 1, 1994, and May 1, 2015. Results. This study included a total of 1449 patients with chronic hepatitis C and 2377 control cases. The prevalence of H. pylori was significantly higher in patients with chronic hepatitis C than in those without chronic hepatitis C. The pooled odds ratio was 2.93. In a subgroup analysis, the odds ratios were 4.48 for hepatitis C virus- (HCV-) related cirrhosis and 5.45 for hepatocellular carcinoma. Conclusion. Our study found a strong association between H. pylori and chronic hepatitis C, particularly during the HCV progression stage; thus, we recommend active screening for H. pylori in patients with chronic hepatitis C.
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Zhang XH, He Y, Feng R, Xu LP, Jiang Q, Jiang H, Lu J, Fu HX, Liu H, Wang JW, Wang QM, Feng FE, Zhu XL, Xu LL, Xie YD, Ma H, Wang H, Liu KY, Huang XJ. Helicobacter pylori infection influences the severity of thrombocytopenia and its treatment response in chronic hepatitis B patients with compensatory cirrhosis: A multicenter, observational study. Platelets 2015; 27:223-9. [PMID: 26338255 DOI: 10.3109/09537104.2015.1077946] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The role of Helicobacter pylori (H. pylori) infection on thrombocytopenia in chronic hepatitis B (CHB) related compensatory cirrhotic patients is unknown. We conducted an observational study to determine whether H. pylori plays a role in these patients. A total of 255 patients from three centers in China were enrolled in the study. All patients received nucleoside analogs (NA) therapy and were screened for H. pylori infection. Patients were divided into three groups based on their H. pylori infection status and the therapy administered: patients without H. pylori infection who received NA therapy alone (N = 146); patients with H. pylori infection who received NA therapy alone (n = 48); and patients with H. pylori infection who received H. pylori eradication combined with NA therapy (N = 61). We observed that in CHB compensatory cirrhotic patients with H. pylori infection, the platelets count was significantly lower relative to uninfected patients (31 versus 60 × 10(9)/L, p < 0.01). During a 2-year follow-up, the elevation in platelet count was significantly higher in HBV/H. pylori co-infected patients who received the NA and H. pylori eradication treatment compared to the other two groups (p < 0.01). It suggested that H. pylori infection and eradication treatment combined with NA were independent risk factors associated with platelets response during treatment of thrombocytopenia in CHB compensatory cirrhosis (p < 0.01). In conclusion, H. pylori infection may associate with thrombocytopenia in CHB compensatory cirrhosis. H. pylori eradication combined with NA treatment may prove to be beneficial to CHB compensatory cirrhotic patients with thrombocytopenia who are infected with H. pylori.
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Affiliation(s)
- Xiao-Hui Zhang
- a Peking University People's Hospital, Institute of Hematology , Beijing , China
| | - Yun He
- a Peking University People's Hospital, Institute of Hematology , Beijing , China
| | - Ru Feng
- b Department of Hematology , Beijing Hospital, Ministry of Health , Beijing , China
| | - Lan-Ping Xu
- a Peking University People's Hospital, Institute of Hematology , Beijing , China
| | - Qian Jiang
- a Peking University People's Hospital, Institute of Hematology , Beijing , China
| | - Hao Jiang
- a Peking University People's Hospital, Institute of Hematology , Beijing , China
| | - Jin Lu
- a Peking University People's Hospital, Institute of Hematology , Beijing , China
| | - Hai-Xia Fu
- a Peking University People's Hospital, Institute of Hematology , Beijing , China
| | - Hui Liu
- b Department of Hematology , Beijing Hospital, Ministry of Health , Beijing , China
| | - Jing-Wen Wang
- c Department of Hematology , Beijing Tongren Hospital , Beijing , China , and
| | - Qian-Ming Wang
- a Peking University People's Hospital, Institute of Hematology , Beijing , China
| | - Fei-Er Feng
- a Peking University People's Hospital, Institute of Hematology , Beijing , China
| | - Xiao-Lu Zhu
- a Peking University People's Hospital, Institute of Hematology , Beijing , China
| | - Lin-Lin Xu
- a Peking University People's Hospital, Institute of Hematology , Beijing , China
| | - Yang-Di Xie
- d Peking University People's Hospital, Institute of Hepatic Diseases , Beijing , China
| | - Hui Ma
- d Peking University People's Hospital, Institute of Hepatic Diseases , Beijing , China
| | - Hao Wang
- d Peking University People's Hospital, Institute of Hepatic Diseases , Beijing , China
| | - Kai-Yan Liu
- a Peking University People's Hospital, Institute of Hematology , Beijing , China
| | - Xiao-Jun Huang
- a Peking University People's Hospital, Institute of Hematology , Beijing , China
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Sakr SA, Badrah GA, Sheir RA. Histological and histochemical alterations in liver of chronic hepatitis C patients with Helicobacter pylori infection. Biomed Pharmacother 2013; 67:367-74. [PMID: 23659901 DOI: 10.1016/j.biopha.2013.03.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 03/03/2013] [Indexed: 02/07/2023] Open
Abstract
Hepatitis C is an infectious disease affecting the liver. Chronic infection can progress fibrosis and cirrhosis, liver failure or liver cancer. Helicobacter pylori (H. pylori) is a spiral bacterium infects the stomach of more than 50% of the human population worldwide. H. pylori DNA has been identified in human livers and has been implicated in chronic liver disease and liver cancer. The present work was aimed to study the histological and histochemical alterations in liver of HCV patients with or without H. pylori infection. Immunohistochemical detection of H. pylori showed positive reactivity in 62 biopsies out of 100 biopsies (38% HCV patients and 62% HCV patients coinfected with H. pylori). Histological examination of liver of HCV patients showed microvesicular and macrovesicular steatosis, lymphocytic infiltrations, fibrosis and cirrhosis. Cirrhotic nodules and impairment of hepatic parenchyma were common in HCV patients coinfected with H. pylori. HCV patients coinfected with H. pylori recorded higher NIC score and pronounced fibrosis stages than HCV patients. Glycogen and total proteins decreased in hepatocytes and cirrhotic nodules in HCV patients. Such decrease was marked in liver of HCV patients coinfected with H. pylori. So it is recommended to perform a complete analysis for H. pylori in HCV patients suggesting that it will help in therapy of this disease.
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Affiliation(s)
- Saber A Sakr
- Zoology Department, Faculty of Science, Menoufia University, Menoufia, Egypt.
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Furusyo N, Walaa AH, Eiraku K, Toyoda K, Ogawa E, Ikezaki H, Ihara T, Hayashi T, Kainuma M, Murata M, Hayashi J. Treatment for Eradication of Helicobacter pylori Infection among Chronic Hepatitis C Patients. Gut Liver 2011; 5:447-53. [PMID: 22195242 PMCID: PMC3240787 DOI: 10.5009/gnl.2011.5.4.447] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 04/19/2011] [Accepted: 04/19/2011] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND/AIMS Helicobacter pylori infection causes gastritis, peptic ulcers and gastric malignancies, and its eradication has been advocated by many groups. We determined the H. pylori carrier status and eradication rates of patients with chronic hepatitis C virus (HCV) infection. METHODS In total, 76 chronically HCV-infected patients were enrolled for comparison with 228 HCV-noninfected, age- and sex-matched controls. H. pylori infection was confirmed by H. pylori antibody and urea breath testing. RESULTS The H. pylori infection rate was significantly higher for HCV-infected patients (67 of 76, 88.2%) than for HCV-noninfected controls (158 of 228, 69.3%). Endoscopic findings showed that the rates of gastric ulcers and gastritis were significantly higher for the 67 HCV-infected patients with H. pylori infection (34.3% and 77.6%) than for the 158 HCV-noninfected controls with H. pylori infection (15.2% and 57.6%). Treatment to eradicate H. pylori had a significantly higher success rate for HCV-infected patients (61 of 67, 91.0%) than for HCV-noninfected controls (115 of 158, 72.8%). CONCLUSIONS The markedly high H. pylori eradication rate observed in this study shows that eradication of H. pylori holds promise for the improvement of the long-term health condition of patients with chronic HCV infection.
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Affiliation(s)
- Norihiro Furusyo
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Environmental Medicine and Infectious Diseases, Kyushu University, Fukuoka, Japan
| | - Ahmed H. Walaa
- Department of Environmental Medicine and Infectious Diseases, Kyushu University, Fukuoka, Japan
| | - Kunimitsu Eiraku
- Department of Environmental Medicine and Infectious Diseases, Kyushu University, Fukuoka, Japan
| | - Kazuhiro Toyoda
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Eiichi Ogawa
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Hiroaki Ikezaki
- Department of Environmental Medicine and Infectious Diseases, Kyushu University, Fukuoka, Japan
| | - Takeshi Ihara
- Department of Environmental Medicine and Infectious Diseases, Kyushu University, Fukuoka, Japan
| | - Takeo Hayashi
- Department of Environmental Medicine and Infectious Diseases, Kyushu University, Fukuoka, Japan
| | - Mosaburo Kainuma
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Environmental Medicine and Infectious Diseases, Kyushu University, Fukuoka, Japan
| | - Masayuki Murata
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Jun Hayashi
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Environmental Medicine and Infectious Diseases, Kyushu University, Fukuoka, Japan
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Lönngren V, Nilsson I, Verbaan H, Wadström T, Ljungh A. High levels of serum antibodies to cell surface proteins of Helicobacter pullorum and Helicobacter pylori in hepatitis C virus-infected patients. Scand J Gastroenterol 2009; 44:505-6. [PMID: 18821131 DOI: 10.1080/00365520802449294] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Vincent Lönngren
- Department of Laboratory Medicine, Division of Medical Microbiology, Lund University, Lund, Sweden.
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