title: Active peptic ulcer disease in patients with hepatitis C virus-related cirrhosis: the role of Helicobacter pylori infection and portal hypertensive gastropathy.
abstract: OBJECTIVE
  The relationship between Helicobacter pylori infection and peptic ulcer disease in cirrhosis remains controversial. The purpose of the present study was to investigate the role of H pylori infection and portal hypertension gastropathy in the prevalence of active peptic ulcer among dyspeptic patients with compensated hepatitis C virus (HCV)-related cirrhosis.
  
  
  METHODS
  Patients undergoing upper endoscopy with compensated HCV-related cirrhosis were enrolled. Child-Pugh's score was determined at the entry. Variceal size was measured endoscopically and the severity of portal hypertensive gastropathy was graded. H pylori infection status was determined by urea breath testing and/or histology.
  
  
  RESULTS
  A total of 178 patients positive for HCV (A and B Child-Pugh's score) were prospectively included. The prevalence of H pylori infection was 43%. An active peptic ulcer was found in 14 patients (8%) and was significantly more common among those with H pylori infection (16% versus 2% in H pylori uninfected patients, odds ratio: 8.0). No association was observed between H pylori infection and variceal size, or hypertensive gastropathy.
  
  
  CONCLUSIONS
  Patients with compensated cirrhosis and H pylori infection showed higher risk of developing a peptic ulcer. Clinical relevance of this result would be that dyspeptic patients with HCV-related cirrhosis may benefit from preventive screening and eradication of H pylori, especially those with features of insufficient hemostasis.
authors.affiliation: Istituto di Clinica Medica, Università degli Studi di Sassari, Italy. mpdore@ssmain.uniss.it
authors.forename: Maria Pina
authors.initials: MP
authors.lastname: Dore
authors.forename: Daniela
authors.initials: D
authors.lastname: Mura
authors.forename: Stefania
authors.initials: S
authors.lastname: Deledda
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Maragkoudakis
authors.forename: Antonella
authors.initials: A
authors.lastname: Pironti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Realdi
mesh_terms: D015897:Comorbidity; D016099:Endoscopy, Gastrointestinal; D016481:Helicobacter Infections / Q000453:epidemiology*; D016480:Helicobacter pylori; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000821:virology; D010437:Peptic Ulcer / Q000382:microbiology*; D015995:Prevalence; D013272:Stomach Diseases / Q000150:complications*