title: Helicobacter pylori Infection Is Associated with Higher CD4 T Cell Counts and Lower HIV-1 Viral Loads in ART-Naïve HIV-Positive Patients in Ghana.
abstract: BACKGROUND
  Worldwide, there is a high co-endemicity of HIV and H. pylori infection and there is growing evidence that H. pylori co-infection is associated with parameters of HIV disease progression. The objective of this study was to investigate the prevalence of H. pylori infection, and the association with clinical, immunological and virological parameters in a large cohort of HIV-infected individuals and uninfected controls in a West African country.
  
  
  METHODS
  HIV-patients (n = 1,095) and HIV-negative individuals (n = 107) were recruited at a university hospital in Ghana. H. pylori status was determined using stool antigen testing. HIV-related, clinical and socio-demographic parameters were recorded and analyzed according to H. pylori status.
  
  
  RESULTS
  The prevalence of H. pylori infection was significantly lower in HIV-positive compared to HIV-negative individuals (51.5 vs. 88%, p<0.0001). In HIV patients, H. pylori prevalence decreased in parallel with CD4+ T cell counts. In ART-naïve HIV-infected individuals, but not in those taking ART, H. pylori infection was associated with higher CD4 cell counts (312 vs. 189 cells/μL, p<0.0001) and lower HIV-1 viral loads (4.92 vs. 5.21 log10 copies/mL, p = 0.006). The findings could not be explained by socio-demographic confounders or reported use of antibiotics. Having no access to tap water and higher CD4+ T cell counts were identified as risk factors for H. pylori infection.
  
  
  CONCLUSIONS
  H. pylori prevalence was inversely correlated with the degree of immunosuppression. In ART-naïve individuals, H. pylori infection is associated with favorable immunological and virological parameters. The underlying mechanisms for this association are unclear and warrant investigation.
authors.affiliation: Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.|Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: Fred Stephen
authors.initials: FS
authors.lastname: Sarfo
authors.affiliation: Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
authors.forename: Kirsten Alexandra
authors.initials: KA
authors.lastname: Eberhardt
authors.affiliation: Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: Albert
authors.initials: A
authors.lastname: Dompreh
authors.affiliation: Clinic of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Düsseldorf, Germany.
authors.forename: Edmund Osei
authors.initials: EO
authors.lastname: Kuffour
authors.affiliation: Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
authors.forename: Mareike
authors.initials: M
authors.lastname: Soltau
authors.affiliation: Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
authors.forename: Marei
authors.initials: M
authors.lastname: Schachscheider
authors.affiliation: Institute of Virology, University of Bonn Medical Centre, Bonn, Germany.
authors.forename: Jan Felix
authors.initials: JF
authors.lastname: Drexler
authors.affiliation: Institute of Virology, University of Bonn Medical Centre, Bonn, Germany.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Eis-Hübinger
authors.affiliation: Clinic of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Düsseldorf, Germany.
authors.forename: Dieter
authors.initials: D
authors.lastname: Häussinger
authors.affiliation: Kumasi Centre for Collaborative Research, Kumasi, Ghana.
authors.forename: Emelia Efua
authors.initials: EE
authors.lastname: Oteng-Seifah
authors.affiliation: Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.|Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: George
authors.initials: G
authors.lastname: Bedu-Addo
authors.affiliation: Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.|Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: Richard Odame
authors.initials: RO
authors.lastname: Phillips
authors.affiliation: Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.|Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: Betty
authors.initials: B
authors.lastname: Norman
authors.affiliation: Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
authors.forename: Gerd
authors.initials: G
authors.lastname: Burchard
authors.affiliation: Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.|Clinic of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Düsseldorf, Germany.
authors.forename: Torsten
authors.initials: T
authors.lastname: Feldt
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D016516:CD4-CD8 Ratio; D060085:Coinfection; D005260:Female; D005869:Ghana / Q000453:epidemiology; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology* / Q000821:virology*; D015497:HIV-1 / Q000276:immunology*; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000276:immunology*; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D019562:Viral Load; D055815:Young Adult