Prevalence Of Helicobacter Pylori In HIV/AIDS Patients And Effect Of Eradication Of Helicobacter Pylori On Immune Reconstruction

Background and Objective:Human immunodeficiency virus（HIV）and Helicobacter pylori（Hp）infection are both serious global public health problems.Researchers found that even if the patients of the same gender and age were infected with the same type of HIV,and the same highly active antiretroviral therapy（HAART）was used,the time and clinical outcome of their progress to acquired immune deficiency syndrome（AIDS）were different.Therefore,to explore the factors that affect the clinical outcome of HIV/AIDS patients and the efficacy of HAART has become a hot issue in recent years.With the development of the study on the pathogenesis of Hp infection,it is found that Hp is not only related to gastrointestinal diseases such as peptic ulcer,but also closely related to the occurrence and development of extragastric diseases.In recent years,the interaction between Hp infection and HIV/AIDS patients has aroused widespread concern.Considering that HIV and Hp infection are often affected by regional,cultural and economic factors,this study focuses on the population in Guangxi from the following two aspects:1.To analyze the HP infection status of HIV/AIDS patients in Beihai and the relationship between Hp infection and host immune status;2.To analyze the effect of Hp eradication on HAART in HIV/AIDS patients.Methods:179 HIV/AIDS patients were selected as the observation group in Beihai people’s Hospital from January 2016 to December 2018,and 120HIV-negative people were selected as the control group.Western blotting was used to detect the Hp antibody in all subjects,and flow cytometry was used to detect the level of CD4⁺T lymphocytes in HIV/AIDS patients.The prevalence of Hp among HIV/AIDS patients and HIV-negative patients was analyzed,and the prevalence rate of Hp among HIV/AIDS patients with different immune functions was analyzed.Multivariate regression analysis was conducted on the influencing factors of Hp infection in HIV/AIDS patients.The HIV/AIDS patients with antibody-positive of Hp were tested by ¹³C/¹⁴C-urea breath test to determine whether there was Hp infection,and these patients were divided into Hp eradication treatment group and Hp non-eradication treatment group.To compare the CD4⁺T lymphocyte count between HIV/AIDS patients who had successfully eradicated Hp and those who had not eradicated Hp at 24W and48W after HAART.Spss23.0 was used for statistical analysis of the data.The measurement data conforming to the normal distribution were expressed as X±SD.T-test was used for inter group comparison of measurement data,and F-test was used for multi group comparison.The statistical data were expressed by N/%,andχ^2-test was used for comparison of statistical data.Logistic regression was used to analyze the risk factors of Hp infection in HIV/AIDS patients.When P<0.05,it can be considered that the difference is statistically significant.Results:1.The prevalence of Hp in HIV/AIDS patients（37.43%）was significantly lower than that in healthy people（52.50%）（P<0.05）;the prevalence of type I Hp in HIV/AIDS patients was 20.11%,significantly lower than that in healthy people（35.83%）（P<0.05）.2.The baseline CD4⁺T lymphocyte count of Hp positive HIV/AIDS patients was 369.48/μl,significantly higher than that of Hp negative HIV/AIDS patients（243.74/μl）（P<0.05）;the CD4⁺T lymphocyte count of type I Hp positive HIV/AIDS patients was 427.78/μl,significantly higher than that of type II Hp positive HIV/AIDS patients（302.93/μl）（P<0.05）.3.The prevalence of Hp was significantly different among the four groups with different immune function（χ²=4.246,P=0.039）.The higher the baseline CD4⁺T lymphocyte level,the higher the the prevalence of Hp.4.Logistic analysis showed that high levels of CD4⁺T lymphocytes（3.462,1.373-8.732,0.009）and HBV/HCV infection（2.917,1.011-8.414,0.048）were independent risk factors for HIV/AIDS patients with Hp infection.5.At 24W after HAART,the CD4⁺T lymphocyte count of HIV/AIDS patients who had successfully eradicated Hp was close to that of those who had not（P>0.05）.At 48W after HAART,the CD4⁺T lymphocyte count of HIV/AIDS patients who successfully eradicated Hp was 499.68/μl,but only 451.06/μl in those who had not eradicated Hp,P<0.05.Conclusions:1.The prevalence of Hp in HIV/AIDS patients was significantly lower than that in HIV-negative people.2.In HIV/AIDS patients,the prevalence of Hp is positively correlated with the level of CD4⁺T lymphocytes,and the high level of CD4⁺T lymphocytes is an independent risk factor of Hp infection in HIV/AIDS patients.It is suggested that perfect immune function may be beneficial to Hp infection and colonization in gastric mucosa.3.In HIV/AIDS patients,the prevalence of type I Hp is significantly lower than that in type II Hp patients,suggesting that Hp specific virulence factors may play a key role in HIV/Hp co-infection4.At 48W after HAART,the CD4⁺T lymphocyte count of HIV/AIDS patients who had successfully eradicated Hp was significantly higher than that of those who had not,suggesting that eradicating Hp may be helpful to the immune reconstruction of HIV/AIDS patients.