Helicobacter infection and cirrhosis in hepatitis C virus carriage: is it an innocent bystander or a troublemaker?

Since it has been shown that Helicobacter hepaticus causes both chronic hep atitis and hepatocellular carcinoma (HCC) in mice, it is suggested that dif ferences in the progression of chronic hepatitis C may be due to a cofactor stemming from co-infection by bacteria, especially Helicobacter pylori, an d/or other Helicobacter species. An assessment was made of the prevalence o f H. pylori infection in HCV-positive cirrhotic patients. The presence of H elicobacter species (spp). was evaluated in resected liver tissue from HCC patients. Serum anti-hi pylori IgG antibodies were determined in 70 males with a clin ical and/or histological diagnosis of cirrhosis and HCV infection and in 31 0 age-matched male blood donors. The prevalences of H. pylori antibody were 77% (54/70) and 59% (183/310) (P 0.004). Primers identifying 26 Helicobacter species were used to determine the pres ence of the genomic 16S rRNA of this genus in liver tissue resected from 25 cirrhotic HCC patients. Genomic sequences corresponding to H. pylori and H . pullorum were identified in 23 of these 25 livers. Together, these findings support the proposal that H. pylori is implicated in the pathogenesis and progression of cirrhosis, particularly in HCV-infec ted individuals. Involvement of Helicobacter spp. in HCC also seems highly possible. (C) 2000 Harcourt Publishers Ltd.