Helicobacter pylori and its hematological effect

The association of Helicobacter pylori infection with the risk of anemia in children: systematic review and meta-analysis

BACKGROUND

Children are among the most vulnerable groups for Helicobacter pylori (H. pylori) infection, which was linked with an increased risk of anemia. H. pylori infection may cause the development of anemia through affecting the absorption of different micronutrients and increasing hepcidin production from hepatocytes. This study aimed to assess the effect of H. pylori infection on the occurrence of anemia in children.

METHODOLOGY

Previously published articles were systematically searched on major databases including Science Direct, PubMed, Embase, Scopus, Cochrane Library, and Science Citation Index using search terms. The search results were imported into EndNote X9 to organize and remove duplicates. Then, relevant data was extracted and analyzed using STATA version 16.0. The pooled odds ratio (OR) was calculated to evaluate the associations of H. pylori infection with Anemia. Moreover, pooled standardized mean difference (SMD) of Hemoglobin (Hgb) and Serum ferritin (SF) levels between cases and controls were calculated for group comparisons.

RESULTS

A total of nine published articles were included in this study. The result showed that H. pylori-infected children had 2.68 times more risk of developing anemia compared to H. pylori-negative children (OR: 2.68:95% CI:1.44-4.99, p = 0.002). Subgroup analyses based on study design showed an increased significant association between H. pylori infection and anemia among case-control studies (OR:3.792:95%CI;1.767, 8.142, p = 0.001). Subgroup analyses based on the H. pylori detection method indicated an increased significant association between H. pylori infection and anemia when the stool antigen test method was used (OR:3.801;95%CI:1.090,13.250, p = 0.036). Moreover, there was a significant decrement of Hgb and SF levels in the H. pylori positive group compared to the negative group with SMD of -0.54(95%CI: -0.65, -0.42, p < 0.001) and - 0.49(95% CI: -0.91, -0.08, p < 0.020), respectively.

CONCLUSIONS

This study revealed that children with H. pylori infection are at a higher risk of developing anemia as compared to non-infected children. Moreover, the observed decrease in Hgb and SF levels in infected children suggests that H. pylori may contribute to the development of anemia. Future research need to focus on the mechanisms by which H. pylori infection contributes to anemia, as well as the potential benefits of targeted interventions in reducing both H. pylori prevalence and anemia rates in children.

Comparison of hematologic parameters, serum electrolytes, and lipid profiles among dyspeptic patients with and without Helicobacter pylori infection attending Jimma Medical Center, Jimma, South West Ethiopia

BACKGROUND

About half of the world's populations are infected with Helicobacter pylori, which may create atherogenic lipid profiles and contribute to atherosclerosis and related cardiovascular disease. Furthermore, it has been connected to hematological symptoms like anemia. Even though the high prevalence of H.pylori and its associated complications, including cardiovascular disease and anemia, in Ethiopia, there is little data regarding the risk factors associated with H.pylori infection, such as hematologic parameters, electrolyte imbalances, and lipid profiles.

METHODS

A comparative cross-sectional study design with a consecutive sampling technique was employed at Jimma Medical Center among 108 dyspeptic patients. Five (5) ml of blood samples were collected from each participant, and serum was extracted and analyzed using a COBAS 6000 core for the lipid and electrolyte, and whole blood was used with a SYSMEX XN 550 to determine hematological parameters. Data were entered in to Epi-data version 4.6 and exported to SPSS version 25 for analysis. Simple descriptive statistics and chi-square test were used to present the socio-demographic characteristics of the study subjects. Student t-test was used for data comparison and p-value < 0.05 was considered statistically significant.

RESULTS

H.pylori infected patients had significantly decreased levels of red blood cell count (p = 0.002), hemoglobin (p = 0.012), mean corpuscular hemoglobin concentration (p < 0.001), platelet count (p = 0.001), and sodium level (p = 0.006) when compared to the uninfected group. However, total cholesterol (p = 0.001), and low density lipoprotein (p = 0.021) were increased in H.pylori infected patients when compared to the uninfected group.

CONCLUSIONS

This study revealed that H.pylori infection can cause derangements of hematologic parameters, electrolyte imbalances, and alterations of lipid parameters which considered as risk factors for anemia and cardiovascular diseases.

Helicobacter pylori (H. pylori) Infection-Associated Anemia in the Asir Region, Saudi Arabia

H. pylori (ubiquitous) and anemia together represent one of the growing health concerns globally. Gastroduodenal sequelae of H. pylori infection are distinguished; however, for the H. pylori infection and its implication in the development of anemia, iron has a significant health impact. We aimed to evaluate H. pylori infection-associated anemia by employing a logistic regression analysis model. A retrospective (case-control) study design-based assessment of the H. pylori associated-anemia. The study area was geo-referenced by QGIS/QuickMapServies. Descriptive and inferential statistical analyses were accomplished using the R-base-R-studio (v-4.0.2)-tidyverse. A p-value < 0.05 was the statistical significance cut-off value. A ggplot2 package was used for data representation and visualization. Mean ± SD age, Hb, MCV, ferritin, and RBC for overall study participants were measured to be 44.0 ± 13.58, 13.84 ± 2.49, 83.02 ± 8.31, 59.42 ± 68.37, and 5.14 ± 0.75, respectively. Decreased levels of Hb (infected vs. uninfected: 13.26 ± 2.92 vs. 14.42 ± 1.75, p < 0.001) ferritin (infected vs. uninfected: 48.11 ± 63.75 vs. 71.17 ± 71.14, p < 0.001), and MCV (infected vs. uninfected: 81.29 ± 9.13 vs. and 84.82 ± 6.93, p < 0.05) were measured to be associated with H. pylori infection when compared with H. pylori uninfected control group. Moreover, the magnitude (prevalence) of anemia (infected vs. uninfected: 78% vs. 21%, p < 0.001), iron deficiency anemia (IDA) (infected vs. uninfected: 63.3% vs. 36.6%, p < 0.001), and microcytic anemia (infected vs. uninfected: 71.6% vs. 46.1%, p < 0.001) were significantly different among the H. pylori-infected participants. The higher likelihood of developing anemia (AOR; 4.98, 95% CI; 3.089-8.308, p < 0.001), IDA (AOR; 3.061, 95% CI; 2.135-4.416, p < 0.001), and microcytic anemia (AOR; 3.289, 95% CI; 2.213-4.949, p < 0.001) by 398%, 206.1%, and 229%, respectively, was associated with H. pylori-infected. We recommend the regular monitoring of hematological parameters and eradication of H. pylori infection to minimize the extra-gastric health consequences of H. pylori infection.

Helicobacter pylori Infection: Current Status and Future Prospects on Diagnostic, Therapeutic and Control Challenges

Helicobacter pylori (H. pylori) infection, which affects approximately half of the world's population, remains a serious public health problem. As H. pylori infection leads to a number of gastric pathologies, including inflammation, gastroduodenal ulcers, and malignancies, early detection and treatment are crucial to preventing the spread of the infection. Multiple extragastric complications, such as iron deficiency anaemia, immune thrombocytopenic purpura, vitamin B12 deficiency, diabetes mellitus, cardiovascular diseases, and certain neurological disorders, have also been linked to H. pylori infection. An awareness of H. pylori and associated health hazards is necessary to minimize or even eradicate the infection. Therefore, there is an urgent need to raise the standards for the currently employed diagnostic, eradication, alternative treatment strategies. In addition, a brief overview of traditional and cutting-edge approaches that have proven effective in identifying and managing H. pylori is needed. Based on the test and laboratory equipment available and patient clinical characteristics, the optimal diagnostic approach requires weighing several factors. The pathophysiology and pathogenic mechanisms of H. pylori should also be studied, focusing more on the infection-causing virulence factors of this bacterium. Accordingly, this review aims to demonstrate the various diagnostic, pathophysiological, therapeutic, and eradication tactics available for H. pylori, emphasizing both their advantages and disadvantages. Invasive methods (such as quick urease testing, biopsy, or culture) or noninvasive methods (such as breath tests, stool investigations, or serological tests) can be used. We also present the most recent worldwide recommendations along with scientific evidence for treating H. pylori. In addition to the current antibiotic regimens, alternative therapies may also be considered. It is imperative to eradicate the infections caused by H. pylori as soon as possible to prevent problems and the development of stomach cancer. In conclusion, significant advances have been made in identifying and treating H. pylori. To improve eradication rates, peptide mass fingerprinting can be used as a diagnostic tool, and vaccines can also eliminate the infection.

Helicobacter pylori-Related Extraintestinal Manifestations—Myth or Reality

It is well documented that Helicobacter pylori (H. pylori) can cause both gastrointestinal and extraintestinal manifestations. The latter one represents a major burden in terms of diagnosis and treatment. H. pylori-associated systemic subclinical inflammation is mostly responsible for the development of extraintestinal manifestations, and its early eradication might result in preventing all adverse events related to their occurrence. Thus, it was suggested that H. pylori might be associated with iron deficiency anemia, thrombocytopenia (immune thrombocytopenic purpura), Schonlein Henoch purpura, failure to thrive, vitamin B12 deficiency, diabetes mellitus, body mass index, cardiovascular diseases, as well as certain neurological conditions. Nevertheless, studies showed both pros and cons in terms of the role of H. pylori in the development of previously mentioned clinical entity underlining the crucial need for further studies on these topics. Although most of these extraintestinal manifestations occur during adulthood, we must not forget that H. pylori infection is acquired mainly during childhood, and thus its early diagnosis and eradication might represent the cornerstone in the prevention of H. pylori-induced inflammatory status and consequently of all related extraintestinal conditions.

Evaluation of Hematological Parameters of Helicobacter pylori-Infected Adult Patients at Southern Ethiopia: A Comparative Cross-Sectional Study

BACKGROUND

Helicobacter pylori (H. pylori) infection is a global public health problem, a higher burden of the infection was reported in developing countries including Ethiopia. It has been associated with several gastrointestinal diseases, and recently implicated in some hematological abnormalities. Despite the high prevalence of H. pylori infection in Ethiopia, there was limited data regarding the relationship between hematological parameters with H. pylori infection. Therefore, this study aimed to evaluate selected hematological parameters of H. pylori-infected patients attending Wachemo University Nigist Eleni Mohammed Memorial Referral Hospital (WUNEMMRH), Hosanna, Southern, Ethiopia.

METHODS AND MATERIALS

A comparative cross-sectional study was conducted from January to May 2019 among 374 (187 H. pylori-infected patients and 187controls) study participants. Data on socio-demographic characteristics were collected using a structured questionnaire. A five-milliliter venous blood sample was collected for hematological parameter analysis. Approximately two gram of stool specimen was collected to assess the presence of H. pylori antigen. Data were entered and analyzed by using SPSS version 21. Pearson correlation analysis and independent sample T-test was performed, and P-value < 0.05 was considered statistically significant.

RESULTS

Mean value of Hgb (p<0.001), RBC count (p<0.001), HCT (p<0.001), MCV (p=0.003), MCH (p=0.008), and MCHC (p=0.006) of H. pylori-infected patients were significantly lower than control group. However, the mean value of RDW (p=0.003) in H. pylori-infected patients was significantly higher than in the control group. About 13.3%, 7%, 6.4%, and 18.2% of H. pylori-infected patients showed reduced Hgb concentration, RBC count, HCT, and MCV values, respectively.

CONCLUSION

The study showed a statistically significant difference in the mean value of Hgb, RBC count, HCT, MCV, MCH, MCHC, and RDW of H. pylori-infected patients and controls. Thus, hematological parameters should be considered for proper diagnosis and management of H. pylori-infected patients and eradication of this microorganism from infected patients, determination of hematological parameters for H. pylori-infected patients were recommended.