Helicobacter pylori rate and histopathological evaluation in HBeAg-negative chronic hepatitis B virus infection

Introduction: Studies of Helicobacter pylori (HP) in liver diseases and hepatitis B virus (HBV) infection have been increasingly discussed. Most studies investigating the relationship between HP and HBV have been conducted in patients with cirrhosis and hepatocellular carcinoma (HCC) and usually involving noninvasive tests. The HP frequency in these patients was higher than in healthy controls. No histopathological evaluation was performed in these studies. We investigated the incidence of HP in HBeAg-negative chronic HBV infection (previously termed “inactive carrier”) by using invasive gastric biopsies and carried out histopathological evaluation. Material and methods: We included 90 treatment-naive inactive hepatitis-B carriers as patients. The control group comprised 107 healthy subjects. Biopsies were obtained from the antrum and corpus and were evaluated histopathologically using the Sydney system of classification for gastritis. Results: The rate of HP in inactive hepatitis-B carriers was significantly higher than the control group (75.6% vs. 53.3%, respectively; p = 0.001). There was no difference in incidence of atrophy, intestinal metaplasia, activity, or inflammation (p > 0.05). Peptic ulcer was detected in 11 (12.2%) patients in the HBV group and in 7 (6.5%) patients in the control group (p = 0.360). The incidence of HP was higher in patients with HBV DNA ≥ 2000 IU/ml than in patients with HBV DNA < 2000 IU/ml, but this difference was not statistically significant (85% vs. 68%, respectively; p = 0.062). Conclusions: Although the HP rate in inactive hepatitis-B carriers was higher than the control group, there were no intergroup differences with respect to atrophy, intestinal metaplasia, activity, inflammation, and peptic ulcer frequency.