Host Immune Response and Antibiogram Profiling in Helicobacter Pylori-Induced Peptic Ulcers Disease

Background: This study investigated the antibiogram and host immune response to Helicobacter pylori (H. pylori) infection in Peptic Ulcer Disease (PUD) patients with HIV in a Southwest Nigeria community. Methods: Both healthy controls and symptomatic PUD patients had their blood, stool, and stomach biopsy samples taken for microbiological and immunological testing. The research examined CD4+/CD8+ cell counts, haematological parameters, immunoglobulin levels, cytokines, and HIV serology. Stool antigen testing and culture of H. pylori were conducted, fol-lowed by molecular characterisation, antimicrobial susceptibility testing, and analysis of extended-spectrum beta-lactamase (ESBL) in the isolates. Results: An increased incidence of H. pylori infection was recorded, especially in females between the ages of 17 and 79 years old. Individuals with PUD/HIV co-infection had decreased levels of inflammation and haematological markers. Nei-ther gender nor age had a statistically significant influence on H. pylori culture results (χ ² = 0.441, p = 0.456), stool antigen detection (χ ² = 0.932, p = 1.000), or HIV seropositivity (χ ² = 0.794, p = 0.843). A statistically significant reduction was ob-served in the mean levels of CD8, CD4, IL-1, IL-8, and IgE among HIV-positive individuals co-infected with H. pylori (p < 0.05). Molecular investigation identified 15 H. pylori strains, exhibiting diverse presence of CagA and/or VacA genes, and revealed the highest susceptibility to clarithromycin, alongside resistance to tetracycline and erythromycin. Conclusions: For optimal therapy and patient care, this study concludes that treatment strategies should be customised to consider factors such as antibiotic susceptibility, immunological responses, haematological changes, H. pylori infection, and ESBL formation.