Evidence map›Paper›PMID 26244370›Full record

ArticlePloS one2015

Helicobacter pylori, HIV and Gastric Hypochlorhydria in the Malawian Population.

Joe Geraghty, Alexander Thumbs, Anstead Kankwatira, Tim Andrews, Andrew Moore, Rose Malamba, Neema Mtunthama, Kai Hellberg, Lughano Kalongolera, Paul O'Toole and 3 more

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.8field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 15 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 3 institutions in 2 countries.

Joe GeraghtyDepartment of Gastroenterology, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom; Department of Gastroenterology, Royal Liverpool University Hospital, Liverpool, United Kingdom.
Alexander ThumbsDepartment of Surgery, College of Medicine, Blantyre, Malawi.
Anstead KankwatiraMalawi-Liverpool-Wellcome Trust Clinical Research Programme, PO Box 30096, Blantyre 3, Malawi; Department of Medicine, College of Medicine, Blantyre, Malawi.
Tim AndrewsDepartment of Pathology, Royal Liverpool University Hospital, Liverpool, United Kingdom.
Andrew MooreDepartment of Gastroenterology, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom; Department of Gastroenterology, Royal Liverpool University Hospital, Liverpool, United Kingdom.
Rose MalambaMalawi-Liverpool-Wellcome Trust Clinical Research Programme, PO Box 30096, Blantyre 3, Malawi.
Neema MtunthamaMalawi-Liverpool-Wellcome Trust Clinical Research Programme, PO Box 30096, Blantyre 3, Malawi.
Kai HellbergDepartment of Surgery, College of Medicine, Blantyre, Malawi.
Lughano KalongoleraDepartment of Surgery, College of Medicine, Blantyre, Malawi.
Paul O'TooleDepartment of Gastroenterology, Royal Liverpool University Hospital, Liverpool, United Kingdom.
Andrea VarroDepartment of Cellular and Molecular Physiology, University of Liverpool, United Kingdom.
D Mark PritchardDepartment of Gastroenterology, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom; Department of Gastroenterology, Royal Liverpool University Hospital, Liverpool, United Kingdom.
Melita GordonMalawi-Liverpool-Wellcome Trust Clinical Research Programme, PO Box 30096, Blantyre 3, Malawi; Department of Clinical Infection, Microbiology and Immunology, Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom; Department of Gastroenterology, Royal Liverpool University Hospital, Liverpool, United Kingdom.
University of Liverpool · GBRoyal Liverpool University Hospital · GBMalawi-Liverpool-Wellcome Trust Clinical Research Programme · MW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHIV and Helicobacter pylori are common chronic infections in sub-Saharan Africa. Both conditions can predispose to gastric hypochlorhydria that may be a risk factor for enteric infections and reduced drug absorption. We have investigated to what extent HIV and H. pylori infections are associated with hypochlorhydria in a Malawian cohort of patients undergoing endoscopy.

methods104 sequential symptomatic adults referred for gastroscopy at Queen Elizabeth Central Hospital, Blantyre, Malawi, had blood taken for rapid HIV testing and fasting serum gastrin analysis. Gastric fluid was aspirated for pH testing, and gastric biopsies were taken.

resultsAfter 9/104 HIV-infected patients who were already established on anti-retroviral therapy were excluded, 17/95 (25.0%) were seropositive for untreated HIV, and 68/95 (71.6%) patients were H. pylori positive by histology. Hypochlorhydria (fasting gastric pH>4.0) was present in 55.8% (53/95) of patients. H. pylori infection was significantly associated with hypochlorhydria (OR 2.91, [1.02-7.75], p=0.046). While single infection with HIV was not significantly independently associated with hypochlorhydria. H. pylori and HIV co-infection was more strongly associated with hypochlorhydria (OR 6.25, [1.33-29.43], p=0.020) than either infection alone, suggesting an additive effect of co-infection. HIV infection was associated with higher serum gastrin levels (91.3 pM vs. 53.1 pM, p=0.040), while H. pylori infection was not (63.1 pM vs. 55.1 pM, p=0.610). Irrespective of H. pylori and HIV status, most patients (>90%) exhibited pangastritis. Only three patients had histological evidence of gastric atrophy, of which only one was HIV-infected.

conclusionH. pylori infection was associated with fasting hypochlorhydria, while HIV was not independently associated. HIV and H. pylori co-infection, however, was more strongly associated with hypochlorhydria than H. pylori infection alone. The mechanism of this apparent additive effect between HIV and H. pylori remains unclear, but appears to be related to chronic pangastritis rather than gastric atrophy, and associated with hypergastrinaemia in HIV-infected individuals.

Indexed as

AchlorhydriaAdolescentAdultAgedCoinfectionFemaleGastric AcidGastroscopyHelicobacter InfectionsHelicobacter pyloriHIV InfectionsHumansMalawiMaleMiddle AgedYoung Adult

Identifiers

PMID26244370
PMCPMC4526546
OpenAlexW1666233013

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.