Failure to eradicate Helicobacter pylori infection is more frequent among HIV-positive patients

[en] Objectives: Helicobacter pylori is a worldwide infection, but little is known about the efficacy of treatment for H. pylori infection in HIV-positive patients. The goal of this work was to evaluate outcomes after first-line H. pylori treatment and identify risk factors for failure in HIV-positive patients. Methods: This registry study of unmatched H. pylori-infected HIV-positive patients and HIV-negative obese pre-bariatric surgery controls was performed in a tertiary university hospital. Cases were enrolled from 2006 to 2017, controls from 2007 to 2014, and both received standard of care. An additional 'optimal' subgroup of cases was enrolled prospectively from 2017 to 2019 which was treated only on the basis of antibiogram, drug interaction search and additional support by one referent physician. Helicobacter pylori eradication failure rates were compared according to clinical, microbiological and pathological parameters and treatment. Results: We analysed 258 HIV-positive patients and 204 HIV-negative control patients. Helicobacter pylori eradication failure rates were markedly greater in cases (24.1%) than in controls (8.8%). The proportions of levofloxacin and metronidazole resistance were greater in cases than in controls (P < 0.05). Among cases treated with H. pylori triple therapy (S3T), the 'optimal' subgroup experienced a 9.5% failure rate vs. 28.6% with other strategies (P = 0.01). Risk factors for failure were H. pylori treatment strategy, exposure to antiretroviral treatment, and alcohol status. Overall, positive HIV status was a risk factor for S3T eradication failure. Conclusions: Patients co-infected with H. pylori and HIV frequently failed to eradicate H. pylori and this was related to treatment strategy, antiretroviral exposure and lifestyle.

Disciplines :

Pharmacy, pharmacology & toxicology
Zoology

Author, co-author :

Nkuize, M.

Vanderpas, Jean

Buset, M.

Delforge, M.

Cadière, G.B.

De Wit, S.

Language :

English

Title :

Failure to eradicate Helicobacter pylori infection is more frequent among HIV-positive patients

Publication date :

01 August 2021

Journal title :

HIV Medicine

ISSN :

1464-2662

eISSN :

1468-1293

Publisher :

Blackwell, Oxford, United Kingdom

Volume :

Issue :

Pages :

547-556

Peer reviewed :

Peer Reviewed verified by ORBi

Research unit :

M136 - Chimie thérapeutique et Pharmacognosie

Research institute :

R550 - Institut des Sciences et Technologies de la Santé

Available on ORBi UMONS :

since 18 January 2022

Statistics

Number of views

105 (0 by UMONS)

Number of downloads

73 (0 by UMONS)

More statistics

Scopus citations^®

Scopus citations^®
without self-citations

OpenAlex citations

Bibliography

Malfertheiner P, Megraud F, O’Morain CA et al. Management of Helicobacter pylori infection: the Maastricht IV/ Florence Consensus Report. Gut 2012;61:646e664.
Crowe SE. Helicobacter pylori infection. N Engl J Med 2019; 380: 1158–1165.
Malfertheiner P, Megraud F, O'Morain CA et al. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Gut 2017; 66: 6–30.
Gisbert JP, Pajares JM. Helicobacter pylori “rescue” regimen when proton pump inhibitor-based triple therapy fail. Aliment Pharmacol Ther 2002; 16: 1047–1057.
Vakil N, Megraud F. Eradication therapy for Helicobacter pylori. Gastroenterology 2007; 133: 985–1001.
Shiotani A, Lu H, Pina Dore M et al. Treating Helicobacter pylori effectively while minimizing misuse of antibiotics. Cleve Clin J Med 2017; 84: 310–318.
Fischbach LA, Goodman KJ, Feldman M et al. Sources of variation of Helicobacter pylori treatment success in adults worldwide: a meta-analysis. Int J Epidemiol 2002; 31: 128–139.
Uotani T, Miftahussurur M, Yamaoka Y. Effect of bacterial and host factors on Helicobacter pylori eradication therapy. Expert Opin Ther Targets 2015; 19: 1637–1650.
Furuta T, Shirai N, Takashima M et al. Effect of genotypic differences in CYP2C19 on cure rates for Helicobacter pylori infection by triple therapy with proton pump inhibitor, amoxicillin, and clarithromycin. Clin Pharmacol Ther 2001; 69: 158–168.
Graham DY, Hong L, Yoshio Y. A report card to grade Helicobacter pylori therapy. Helicobacter 2007; 12: 275–278.
Nishimura S, Nagata N, Shimbo T et al. Factors associated with esophageal candidiasis and its endoscopy severity in the era of antiretroviral therapy. PLoS One 2013; 8: e58217.
Nkuize M, De Wit S, Muls V et al. Upper gastrointestinal endoscopic findings in the era of highly active antiretroviral therapy. HIV Med 2010; 11: 412–417.
Nevin TD, Morgan CJ, Graham DY et al. Helicobacter pylori gastritis in HIV-infected patients: a review. Helicobacter 2014; 19: 323–329.
Ali Mohamed FA, Lule GN, Nyong’o A et al. Prevalence of Helicobacter pylori and endoscopic findings in HIV seropositive patients with upper gastrointestinal tract symptoms at Kenyatta National Hospital, Nairobi. East Afr Med J 2002; 79: 226–231.
de Boer WA, Thys JC, Borody TJ et al. Proposal for use of a standard side effect scoring system in studies exploring Helicobacter pylori treatment regimens. Eur J Gastroenterol Hepatol 1996; 8: 641–643.
Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing: 19th informational supplement. Clinical and Laboratory Standards Insitute, document M100-S19, 19th edn. Wayne, Pennsylvania, USA, Clinical and Laboratory Standards Institute.
Miendje Deyi VY, Bontems P, Vanderpas J et al. Routine survey determinations of resistance of Helicobacter pylori to antimicrobials over the last 20 years (1999 to 2009) in Belgium. J Clin Microbiol 2011; 49: 2200–2209.
Dixon MF, Genta RM, Yardley JH et al. Classification and grading of gastritis. Am J Surg Pathol 1996; 20: 1161–1181.
Graham YD, Lee S-Y. How to effectively use bismuth quadruple therapy: the good, the bad, and the ugly. Gastroenterol Clin North Am 2015; 44: 537–563.
Graham DY, Dore MP. Helicobacter pylori therapy: a paradigm shift. Expert Rev Anti Infect Ther 2016; 14: 577–585.
Nkuize M, De Wit S, Muls V et al. HIV-Helicobacter pylori co-infection: antibiotic resistance, prevalence, and risk factors. PLoS One 2015; 10: e0145119.
Breslow NE, Day NE. Design considerations. Part 7. 6. Case-control sampling within a cohort. Statistical methods in cancer research, Vol. II: the design and analysis of cohort studies. IARC scientific publication n° 82. 1987. Lyon, IARC 1987, pp. 271–314.
Epi Info™, Division of Health Informatics and Surveillance (DHIS), Center for Surveillance, Epidemiology and Laboratory Services (CSELS), CDC – Centers for Disease Control and Prevention.
Yager J, Faragon J, McGuey L et al. Relationship between single tablet antiretroviral regimen and adherence to antiretroviral and non-antiretroviral medications among veterans’ affairs patients with human immunodeficiency virus. AIDS Patient Care STDS 2017; 31: 3706.
University of Liverpool. HIV drug interactions tool. https://www.hiv-druginteractions.org/checker.
Zhu L, Persson A, Mahnke L et al. Effect of low-dose omeprazole (20 mg daily) on phamacokinetics of multiple-dose atazanavir with ritonavir in healthy subjects. J Clin Phamacol 2011; 51: 368–377.
Nachega JB, Hsu A, Uthman A et al. Antiretroviral therapy adherence and drug-drug interactions in the aging HIV population. AIDS 2012; 26: S39–S53.
Feierman DE, Melinkov Z, Nanji AA. Induction of CYP3A by ethanol in multiple in vitro and in vivo models. Alcohol Clin Exp Res 2003; 27: 981–988.
Franke A, Teyssen S, Harder H, Singer MV. Effect of ethanol and some alcoholic beverages on gastric emptying in humans. Scand J Gastroenterol 2004; 39: 638–644.
Chey WD, Wong BCY. Practice Parameters Committee of the American College of Gastroenterology American College of Gastroenterology Guideline on the Management of Helicobacter pylori Infection. Am J Gastroenterol 2007; 102: 1808–1825.
Miendje Deyi VY, Vanderpas J, Bontems P et al. Marching cohort of Helicobacter pylori infection over two decades (1988–2007): combined effects of secular trend and population migration. Epidemiol Infect 2011; 139: 572–580.