Impact of Helicobacter pylori infection on liver fibrosis in Egyptian patients with chronic hepatitis C

Both Helicobacter pylori (HP) and hepatitis C virus (HCV) infections are endemic in Egypt. This work aimed to investigate the presence of HP in the liver of patients with chronic hepatitis C (CHC) and explore the relation between HP infection, liver histopathology and HCV viral load. The study included 60 patients with CHC. Virological, biochemical, liver biopsy and testing for anti-Hp and anti-schistosomal antibodies in serum were done. Liver tissues were examined for histopathological and presence of Hp by detection of HP 16S rRNA gene by PCR and sequence analysis. Anti-schistosomal and anti HP antibody was found in 45% and 61.7%, respectively. Low stages of fibrosis (F0–F3) were found in 73.3% and advanced fibrosis (F4–F6) in 26.7%. HP DNA was found in 10% of the liver specimens. Although the frequency HP antibodies was equally high in patients with advanced and low fibrosis (68.8% and 59.1%, P > 0.05), the HP DNA in liver tissue was significantly more frequent in patients with advanced fibrosis (31.25% vs. 2.7%, P = 0.004). Meanwhile, the median viral load of HCV was higher in patients with HP DNA in liver tissue compared to patients with no HP DNA in liver tissue (337.000 vs. 165.000, P = 0.3491). HCV RNA titer, fibrosis score and history of blood transfusion, are independent factors associated with HP DNA in liver tissue. In conclusion, the presence of HP in liver tissue of patients with advanced fibrosis suggests a potential relation between HP infection and progression of liver fibrosis due to HCV.