Meta-analysis of association between Helicobacter pylori infection and multiple sclerosis

Despite recent research focus on the association between Helicobacter pylori (H. pylori) infection and multiple sclerosis (MS) there is no consensus about the findings. To obtain a more comprehensive estimate of the association we conducted a meta-analysis to determine the prevalence of H. pylori infection in MS patients and healthy controls. Pubmed and EMBASE were searched to identify eligible studies. Nine studies were selected for inclusion, involving 2806 cases (1553 patients with MS and 1253 controls). Overall, the prevalence of H. pylori infection in MS patients was lower than that in control groups (24.66% vs. 31.84%, OR = 0.69, 95% CI: 0.57-0.83, P < 0.0001). Subgroup analysis revealed that the levels of H.pylori infection among MS patients were lower than for control subjects in Western countries (11.90% vs. 16.08%, OR = 0.63, 95% CI: 0.43-0.91, P = 0.01), but were not statistically significant in Eastern countries (39.39% vs. 43.82%, OR = 0.79, 95% CI: 0.55-1.14, P = 0.20). Our data show that H. pylori infection and MS is negatively correlated, especially in Western countries. Whether H. pylori infection is a protective factor against MS risk should thus be addressed in large-scale and prospective studies.