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H. pylori did not increase all-cause mortality risk
Patients infected with Helicobacter pylori are not at increased risk for all-cause mortality, but the H. pylori cagA strain can increase the risk for death from certain conditions, according to recent results.
In a prospective cohort study, researchers evaluated data from 9,895 patients enrolled in the National Health and Nutrition Examination Survey III to determine the impact of Helicobacter pylori infection on mortality, both overall and from specific causes. The effect on mortality of the cagA strain of H. pylori also was assessed among evaluable patients (n=7,384).
The cohort included 4,834 patients who tested positive for H. pylori. Among patients with available data on cagA status, 3,124 tested negative for H. pylori, 2,792 were H. pylori cagA-positive and 1,438 had another strain of H. pylori.
No significant association was observed between all-cause mortality and H. pylori status among patients aged older than 40.1 years (HR=1.00; 95% CI, 0.84-1.18) after adjusting for factors including age, sex, education level, BMI, race/ethnicity and tobacco use. H. pylori was not significantly associated with death from cardiovascular or ischemic heart disease, stroke, gastrointestinal cancer or respiratory disease. An association between H. pylori and lung cancer-related mortality neared statistical significance (HR=0.61; 95% CI, 0.35-1.05).
H.pylori was significantly associated with increased risk for death from gastric cancer, both overall (HR=40.95, 4.19-399.92 compared with those without H pylori) and for H. pylori cagA specifically (HR=41.41, 4.09-419.48 compared with those negative for cagA). Significant associations also were observed between H. pylori cagA and death from stroke (HR=0.45, 0.27-0.76) and lung cancer (HR=0.55, 0.31-0.98) (95% CI for all). Further adjustment for factors including health insurance and socioeconomic status and hypertension did not significantly impact these associations.
“Our findings do not suggest that H. pylori colonization is a major risk factor for all-cause mortality,” the researchers wrote. “While the associations observed need to be re-examined in future studies, our results provide further evidence that H. pylori has a mixed role in human health and raise new possible protective effects of H. pylori colonization.”