Abstract
Background: The human immunodeficiency virus (HIV) and Helicobacter pylori (H. pylori) are associated with significant chronic inflammation of the gastric mucosa. Gastric inflammation is a precursor to many gastrointestinal disorders including, peptic ulcer disease, atrophic gastritis (AG) and gastric cancer (GC). AG is usually accompanied by low hydrochloric acid (hypochlorhydria), low pepsinogens (PG) and high gastrin (G) levels and is the most significant risk condition for GC. Acid-free stomach is a risk factor for impaired drug absorption including anti-retroviral therapy and antibiotics. The role of H. pylori infection in HIV-infected subjects has been conflicting. We assessed the prevalence of H. pylori infection, AG and acid-free stomach (hypochlorhydria) amongst HIV/AIDS subjects in Yaounde Cameroon. Methods and materials: A total of 84 HIV/AIDS subjects were recruited in Yaounde (Cameroon) during January-May 2018. Clinical and socio-demographic data of the subjects were recorded. An aliquot of 5 ml of blood was aseptically collected for analysis by GastroPanel® (Biohit Oyj, Helsinki, Finland) biomarker test for PGI, PGII, G-17 and H.pylori IgG antibodies. GastroPanel results were interpreted using the software application GastroSoft® (Biohit). Statistical analyses were run by Epi info 7.0. The study was agreed by the Jammot Hospital of Yaounde, and ethical clearance was obtained from the National Ethics Committee. Results: Results: A total of 84 subjects were recruited, aged between 17-63 years(mean 37.6 ± 8.9 years). H. pyloriseropositivity (IgG ≥30 EIU) was detected in 68(81.0%) of the subjects. H. pyloriseropositivity was closely associated with low CD4 counts (p = 0.01). Altogether, 26(31.0%) of the subjects presented with AG of the corpus while, hypochlorhydria (acid-free stomach) was detected in 32(38.1%) of the patients. AG and hypochlorhydria were associated with low CD4 counts<200 μl/l (p = 0.01) and (p = 0.005), respectively. Conclusion: H. pylori infection, AG and acid-free stomach were common among HIV/AIDS patients, associated with an increased risk for GC and impaired absorption of micronutrients and some medicines.
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