Efficacy of Helicobacter pylori eradication therapy in chronic liver disease.
OBJECTIVE
Peptic ulcers occur more commonly in patients with liver cirrhosis (LC). Helicobacter pylori is recognized as the most important etiology in the pathogenesis of peptic ulcers. We investigated the efficacy of proton pump inhibitor (PPI)-based triple therapy in patients with chronic liver disease and peptic ulcer.


METHODS
One hundred sixty-three patients with LC or chronic hepatitis (CH) with a peptic ulcer and proven H. pylori infection were included. The combination of PPI, amoxicillin (1.0 g), and clarithromycin (500 mg), each given twice daily, was administered for 1 or 2 weeks. The eradication of H. pylori was determined by the rapid urease test, histology, or the 13C-urea breath test at least 4 weeks after completing the treatment.


RESULTS
The eradication rate of H. pylori was similar between the LC and CH groups; 82.6% and 88.1%, respectively. In addition, there were no significant differences in eradication rates between the patients with Child-Pugh class A and Child-Pugh class B/C disease. The side effects in each group were generally mild. Only the serum ALT levels showed a significant correlation with the success of H. pylori eradication in both the LC and CH groups.


CONCLUSIONS
The PPI-based triple therapy achieves high eradication rates for H. pylori infection, in patients with chronic liver disease, without significant side effects.
Jung
S W
SW
Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Ansan Hospital, 516 Gojan-dong, Danwon-gu, Ansan-si, Gyeonggi-do 425-707, South Korea.
Lee
S W
SW
Hyun
J J
JJ
Kim
D I
DI
Koo
J S
JS
Yim
H J
HJ
Park
J J
JJ
Lee
H S
HS
Chun
H J
HJ
Um
S H
SH
Choi
J H
JH
Kim
C D
CD
Ryu
H S
HS
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001944:Breath Tests; D017291:Clarithromycin / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D016145:Endoscopy, Digestive System; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006521:Hepatitis, Chronic / Q000382:microbiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D000658:Amoxicillin; D000410:Alanine Transaminase; D017291:Clarithromycin