Clinic for Infectious and Tropical Disease, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
PLoS One. 2021 Mar 10;16(3):e0248041. doi: 10.1371/journal.pone.0248041. eCollection 2021.
Helicobacter pylori infection does not belong to the spectrum of opportunistic infections in people living with HIV (PLHIV). To evaluate the Helicobacter pylori infection prevalence rate trends in HIV co-infected individuals in comparison to the HIV-negative population, we compared histopathological findings of H. pylori positive gastritis (gastritis topography and histopathology) between 303 PLHIV and 2642 HIV-negative patients who underwent esophagogastroduodenoscopy (EGD) between 1993 and 2014 due to dyspeptic symptoms. The prevalence of H. pylori infection was significantly higher in HIV-negative controls than in PLHIV (50.2% vs. 28.1%). A significantly positive linear trend of H. pylori co-infection in PLHIV was revealed in the observed period (b = 0.030, SE = 0.011, p = 0.013), while this trend was significantly negative in HIV-negative patients (b = - 0.027, SE = 0.003, p < 0.001). Patients with HIV/H. pylori co-infection had significantly higher CD4+ T cell counts and more often had undetectable HIV viremia, due to successful anti-retroviral therapy (ART). Stomach histopathological findings differed between HIV co-infected and H. pylori mono-infected patients. Our findings confirm that the ART has changed the progression of HIV infection, leading to a significant increase in the prevalence of H. pylori infection in dyspeptic PLHIV over time. Our data also suggests that a functional immune system may be needed for H. pylori-induced human gastric mucosa inflammation.
幽门螺杆菌感染不属于人类免疫缺陷病毒（HIV）感染者（PLHIV）机会性感染的范畴。为了评估 HIV 合并感染者中幽门螺杆菌感染的流行率趋势与 HIV 阴性人群相比的变化，我们比较了 1993 年至 2014 年间因消化不良症状接受食管胃十二指肠镜检查（EGD）的 303 例 PLHIV 和 2642 例 HIV 阴性患者的幽门螺杆菌阳性胃炎的组织病理学发现（胃炎的解剖学和组织病理学）。与 HIV 阴性对照组相比，HIV 阳性组的幽门螺杆菌感染率显著降低（50.2%比 28.1%）。在观察期间，PLHIV 中幽门螺杆菌合并感染的呈显著正线性趋势（b = 0.030，SE = 0.011，p = 0.013），而在 HIV 阴性患者中则呈显著负线性趋势（b = - 0.027，SE = 0.003，p < 0.001）。由于成功的抗逆转录病毒治疗（ART），HIV/H. pylori 合并感染患者的 CD4+ T 细胞计数显著升高，且更多患者的 HIV 病毒载量无法检测到。HIV 合并感染者和 H. pylori 单一感染者的胃组织学发现存在差异。我们的研究结果证实，ART 改变了 HIV 感染的进程，导致随着时间的推移，消化不良的 PLHIV 中幽门螺杆菌感染的流行率显著增加。我们的数据还表明，功能性免疫系统可能是幽门螺杆菌引起的人类胃黏膜炎症所必需的。
