Helicobacter pylori infection associated with an increased incidence of cholelithiasis: A retrospective real-world cohort study of 50832 patients.

Abstract

Helicobacter pylori (H.pylori) infection is a bacterial disease of the stomach that has been associated with an increased incidence of cholelithiasis. While the updated German guideline emphasizes the relevance of H.pylori as a pathogen and recommends eradication therapy, systematic data on the association between H.pylori infection, its eradication, and the subsequent diagnosis of cholelithiasis in Germany are missing. A total of 25416 patients with and 25416 propensity score-matched individuals without H.pylori infection were identified from the Disease Analyzer database (IQVIA) between 2005 and 2021. A subsequent diagnosis of cholelithiasis was analyzed as a function of H.pylori infection as well as its eradication using Cox regression models. After 10years of follow-up, 8.0% versus 5.8% of patients with and without H.pylori infection were diagnosed with cholelithiasis (P<0.001). Regression analysis revealed a significant association between H.pylori infection and cholelithiasis (hazard ratio [HR]: 1.45; 95% confidence interval [CI]: 1.33-1.58), which was stronger in men (HR: 1.63; 95% CI: 1.41-1.90) than in women (HR: 1.36; 95% CI: 1.22-1.52). In terms of eradication therapy, both an eradicated H.pylori infection (HR: 1.48; 95% CI: 1.31-1.67) and a non-eradicated H.pylori infection (HR: 1.41; 95% CI: 1.25-1.60) were associated with a subsequent diagnosis of cholelithiasis. The present study reveals a strong association between H.pylori infection and a subsequent diagnosis of cholelithiasis in a large real-world cohort from Germany. Eradication therapy was not associated with a reduced incidence of cholelithiasis in our cohort.