P-15 HELICOBACTER PYLORI AS A RISK FACTOR FOR THE DEVELOPMENT OF MANIFEST ENCEPHALOPATHY AND OTHER COMPLICATIONS IN PATIENTS WITH LIVER CIRRHOSIS AT THE EUGENIO ESPEJO HOSPITAL IN THE PERIOD MAY 2019-JUNE 2022

Introduction and Objectives

It has been suggested that Helicobacter pylori contributes to hyperammonemia in cirrhosis and, with it, to Hepatic Encephalopathy, and the eradication of the bacteria decreases the concentration of ammonia in blood in these patients. Helicobacter pylori may be involved in persistent neurological impairment by promoting the release of involved pro-inflammatory and vasoactive substances, and it may also enter the brain through the oral-nasal-olfactory pathway or through infected circulating monocytes due to defective autophagy by disrupting the blood-brain barrier; producing reactive oxygen metabolites and even influencing the apoptotic process leading to neurodegeneration. This study aimed to describe Helicobacter pylori as a risk factor for the development of manifest encephalopathy and other complications in patients with liver cirrhosis.

Materials and Methods

Case-control study in patients treated at the Eugenio Espejo Hospital, with a diagnosis of liver cirrhosis in the period May 2019- June 2022. The case group consisted of cirrhotic patients with hepatic encephalopathy and the control group of cirrhotic patients without hepatic encephalopathy. The sample was 82 cases and 163 controls. Inferential statistics were applied, using chi-square for the relationship between categorical variables, statistical significance p less than 0.05.

Results

Hepatic encephalopathy occurs more frequently in the female sex with 51.5%, mainly in those over 50 years of age, with primary education, being the most frequent the alcoholic etiology. According to our study, it was determined that patients infected with Helicobacter pylori have a 4.4 fold increase in the possibility of developing manifest hepatic encephalopathy, more than uninfected patients. In addition, Helicobacter pylori infection was related to the presence of hepatocellular carcinoma as a complication, increasing the probability of having it by 2.6 times.

Conclusions

Helicobacter Pylori infection is a risk factor for the development of Hepatic Encephalopathy and is associated with various complications, mainly non-variceal upper gastrointestinal bleeding and hepatocellular carcinoma.