IMPACT OF INFECTION BY HELICOBACTER-PYLORI ON THE RISK AND SEVERITY OF ENDEMIC CHOLERA

To evaluate the relationship between Helicobacter pylori infection and the subsequent risk and severity of endemic Vit,rio cholerae O1 diarr hea among rural Bangladeshis, 285 children and adults with cholera (ca ses) and 881 contemporaneously selected community controls were studie d. Cases and controls were contrasted for H, pylori infection, as mani fested by serum IgG anti-H. pylori antibodies, Although the overall ri sk of cholera was not significantly increased among H. pylori-infected subjects, the risk of cholera of life-threatening severity was signif i::cantly elevated (relative risk [RR] = 1.61; 95% confidence interval [CI] = 1.07-2.42), A significant increase in the risk of severe chole ra was seen in subjects who lacked natural serum vibriocidal antibodie s (RR = 2.88; 95% CI = 1.28-6.48) but not in those with such antibodie s. Thus, H. pylori infection was associated with a significant increas e in the risk of life-threatening cholera, but only among persons lack ing natural vibriocidal immunity.