O-12 HELICOBACTER PYLORI VIRULENCE GENES ARE ASSOCIATED WITH NAFLD SEVERITY: A CROSS SECTIONAL STUDY IN DYSPEPTIC PATIENTS

Introduction and Objectives

Recent studies have suggested an association between Helicobacter pylori (Hpyl) and non-alcoholic fatty liver disease (NAFLD). The current study aimed to examine the association of Hpyl virulence genes and NAFLD in dyspeptic patients.

Materials and Methods

prospective multicenter study from 2019 to 2022 in northeast Argentina. We evaluated 386 dyspeptic patients who fulfilled the ROME III criteria and underwent gastroscopy. NAFLD was defined by ultrasound in the absence of other known liver diseases. cagA, vacAs1/s2, vacAm1/m2 were analyzed by PCR.

Results

The prevalence of NAFLD was 41% (156/383), no association with Hpyl status was observed. In NAFLD subjects, Hpyl+ showed higher AST (Hpyl+: 30 (21) UI/mL vs. Hpyl-: 22 (13) UI/mL, p:0,001), ALT (Hpyl+: 32 (25) UI/mL vs. Hpyl-: 25 (17) UI/mL, p: 0,0018) and FIB-4 (Hpyl+: 1,3 (1) vs. Hpyl-: 0.99 (0.6), p: 0,009). Indeed, Hpyl+ was associated with FIB-4>1,3 (Hpyl+: 54% vs. Hpyl-: 27%, p: 0,009). cagA and vacAm1 were associated with higher ALT (cagA 40 (23) UI/mL, p:0,003, vacAm1 44 (24) UI/mL, p:0,004). Also, higher FIB-4 values were observed with cagA (1,3 (0,9), p: 0,02) and vacAm1 (1.34 (0.8), p: 0,001) with more proportion of patients with FIB-4>1,3 with cagA 54% (p: 0,008) and vacAm1 55% (p: 0.007). The allelic combination vacAs1/m1+cagA showed higher AST (34 (22) UI/mL, p: 0,001), ALT (44 (24) UI/mL, p: 0,004) Fib-4 (1,34 (0,8), p:0.001) with significantly more proportion with FIB-4>1,3 (62%, p: 0,019).

Conclusions

In NAFLD/dyspeptic patients, Hpyl infection was associated with markers of liver injury and fibrosis. cag-A, vacAm1 strains and the allelic combination vacAs1/m1/cagA were associated with higher ALT and FIB-4.