ABSTRACT
Recent studies have suggested that bacterial coinfection with Helicobacter species in patients with hepatitis C virus [HCV] may increase the burden of both infections on the hepatobiliary and gastrointestinal tracts. The aim of this study was to evaluate the association between H. pylori infection and gastric apoptosis in patients with hepatitis C cirrhosis. One hundred consecutive patients with dyspepsia; 50 with posthepatitis C cirrhosis and 50 without hepatitis C or cirrhosis, were studied. The presence of H. pylori was tested by urease test and Gram staining of gastric biopsies. The apoptotic index was calculated in gastric biopsies stained with hematoxylin and eosin. A statistical analysis was done to correlate H. pylori infection with gastric apoptosis in both groups. A verbal consent was taken from all patients after explaining the need for endoscopy and H. pylori testing to diagnose their illness. The accuracy of rapid urease test and Gram staining was almost similar in detection of H. pylori. The results of this study have shown that gastric apoptosis increased significantly in cirrhotic patients with H. pylori infection than non-cirrhotic patients with H. pylori infection. This increase was highly significant in comparison with cirrhotic and non- cirrhotic patients without H. pylori infection. Also, non-cirrhotic patients with H. pylori injection had significantly more gastric apoptosis than cirrhotic and non-cirrhotic patients without H. pylori infection. On the other hand, no significant difference was found in gastric apoptosis between cirrhotic and non-cirrhotic patients without H. pylori infection. In conclusion, H. pylori was associated with more gastric apoptosis. Hepatitis C cirrhosis increases gastric apoptosis in patients with H. pylori infection independent of the degree of cirrhosis and concomitant endoscopic findings including portal hypertensive gastropathy [PHG]. There was an association between H. pylori infection and gastric apoptosis specially in hepatitis C cirrhotic patients. This result warrants prospective studies to determine the possible interaction between H. pylori and HCV in increasing gastric lesions in patients with cirrhosis