P-122 HELICOBACTER PYLORI AS A RISK FACTOR FOR ENCEPHALOPATHY IN PATIENTS WITH CIRRHOSIS

• Published in: Annals of hepatology 2024-12, Vol.29, p.101736
• Main Authors: Partida, Ana Emilia Jiménez, Luevano, Miguel Ángel Jiménez, Cuellar, Alejandro Bravo, Aguilar, Yolanda Cortés, Partida, Miguel Ángel Jiménez
• Format: Article
• Language: English
• ISSN: 1665-2681
• DOI: 10.1016/j.aohep.2024.101736

No Helicobacter pylori (H. pylori) has a high prevalence in Mexico, affecting 66% of the population (associated with 30-50% of gastric pathologies). Cirrhosis of the liver ranks as the sixth leading cause of mortality. This study aims to evaluate the correlation between these two entities in patients with liver cirrhosis. Over a period of 3 years, 148 patients presenting with upper gastrointestinal bleeding were studied. Endoscopy and biopsy confirmed the presence of H. pylori. A certain percentage of these patients also had decompensated liver cirrhosis, assessed through laboratory studies (including prothrombin time), endoscopy with biopsy, elastography, and Child-Pugh classification. A case-control study was conducted, evaluating statistical t-tests, chi-square tests, and odds ratios for both quantitative and qualitative variables. Among the 148 patients with H. pylori, 37 had liver cirrhosis (25%), and among these, 26 had encephalopathy (65%, odds ratio 2.36). The female gender constituted 54%, while males accounted for 46%. The remaining 11 patients (odds ratio 0.041) had a female prevalence of 65% and male prevalence of 35%. According to the Child-Pugh classification, 54% were class A, 31% class B, and 15% class C. Etiologies included obesity and diabetes (58%), alcohol (26%), autoimmunity (8%), and HCV (8%). The correlation between obesity, cirrhosis, H. pylori, and male gender showed an odds ratio of 9.09, while in females, it was 4. Cirrhosis, obesity, and encephalopathy had an odds ratio of 5.36. The mean age for cirrhosis was 60.57, and for cirrhosis with H. pylori and encephalopathy, it was 60.31 (with P < 0.34). H. pylori contributes to over 750,000 deaths annually. In this study, it emerged as a risk factor for encephalopathy in liver cirrhosis patients. Vulnerable groups included women and individuals with obesity and diabetes. Multicenter studies are recommended to assess its true risk factor.