Serodiagnosis of Helicobacter pylori infection in patients with human immunodeficiency virus infection

In contrast to the established role of Helicobacter pylori gastritis in gastritis and duodenal ulcer in general, conflicting results have been reported in patients with human immunodeficiency virus (HIV) infection and the acquired immunodeficiency syndrome. The seroprevalence during early HIV infection is unknown. We retrospectively studied 102 patients with HIV infection early during the infection and in most cases in asymptomatic patients. Serological IgG antibody response to H. pylori was assessed by ELISA. Compared with an age-matched control group the seroprevalence of H. pylori positivity was not significantly different (19% vs 25%). We observed no association with CD4 counts, p24 antigen, antibiotic prophylaxis with sulfamethoxazole/trimethoprim or antiretroviral treatment. In 54 of 83 patients initially seronegative a second examination was performed after a median of 24 months (range 3-60 months) and 2 patients had H. pylori seroconverted, indicating an incidence of new infection of 2%/year. In conclusion, previous reports have underestimated the prevalence of H. pylori infection in HIV patients, which seems to be similar to that in an HIV-negative population.