High Prevalence of Helicobacter pylori Infection, Atrophic Gastritis and Hypochlorhydria in HIV-Positive Cameroonians Tested by Serological Stomach-Specific Biomarkers (GastroPanel®)

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.

Objectives: We assessed the prevalence of H. pylori infection, AG and acid-free stomach (hypochlorhydria) amongst HIV/AIDS subjects in Yaounde Cameroon.

Methods: HIV/AIDS subjects were recruited 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® biomarker test for PGI, PGII, G-17 and H.pylori IgG antibodies. GastroPanel results were interpreted using the software application GastroSoft®. Statistical analyses were run by Epiinfo7.0. Ethical clearance was obtained from the National Ethics Committee.

Results: A total of 84 subjects were recruited, aged between 17-63 years (mean 37.6 ± 8.9 years). H. pylori seropositivity (IgG ≥30 EIU) was detected in 68(81.0%) of the subjects. H. pylori seropositivity 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 was detected in 32(38.1%) of the patients. AG and hypochlorhydria were associated with low CD4 counts<200μl/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.