The Prevalence of Helicobacter Pylori Infection and Peptic Ulcer Disease in HIV-Positive Patients with Gastrointestinal Symptoms Is not Related to Absolute CD4 Counts: A Case-Control Study Prévalence de l'infection à Helicobacter pylori et de l'ulcère peptique chez le sujet VIH-positif en relation avec le taux de CD4: étude cas -témoin

BACKGROUND. The prevalence of Helicobacter pylori (H. pylori) infection and peptic ulcer (PU) in HIV-positive subject was reported to be low in previous studies. The aim of this study was to evaluate the prevalence of H. pylori infection and of PU in relation to absolute CD4 T cells counts in HIV-positive subjects with gastrointestinal symptoms (GI). MATERIAL AND METHODS. One hundred and twelve age- and sex-matched subjects (56 HIV-positive patients and 56 HIV-negative patients) with GI symptoms were assessed by upper endoscopy and gastric biopsies. The prevalence rate of H. pylori infection was the main variable that was assessed. Patients were classified based on HIV status and CD4 count: In Group A: HIV-positive patients with a CD4 count below 200; group B: HIV-positive patients with a CD4 count from 200 to 499; Group C: HIV-positive patients with a CD4 count higher or equal to 500 and group D: HIVnegative control patients. RESULTS. The prevalence rate of H. pylori infection in the four groups was as follow: Group A 42.1% (8/19), group B 65.4% (17/20), group C 27.3 % (3/11) and group D 55.4% (31/56). The prevalence rate of PU was 21.05 % (4/19) in group A, 23.07 % (6/26) in group B, 36.4 % (4/11) in group C (p = 0.07), and 17.85 % (10/56) in group D. The prevalence of H. pylori infection in HIV-positive subjects did not differ between patients with and without PU. Compared with HIV-negative control subjects, HIV-positive subjects with a CD4 count less than 200 had a low prevalence rate of H. pylori infection, this difference was not significant (p = 0.32). The prevalence of PU in HIV-positive subjects with a CD4 count less than 200 was higher compared to that found in HIV-negative control subjects, this difference was not significant (p = 0.97). CONCLUSION. Although the prevalence of H. pylori infection is low in HIV-positive subjects, the PU is contrarily frequent. The H. pylori infection and PU are not in relation to CD4 counts in HIV-positive subjects.