Helicobacter Pylori Infection among Children with Chronic Liver Diseases

Background: Helicobacter pylori (H.pylori) infection is a gastrointestinal pathogen with emerging evidence linking it to chronic liver diseases (CLD). Aim: To investigate the prevalence of H. pylori infection among children with CLD, its endoscopic and histopathological associations, and its effect on disease severity and severity of bleeding. Methods: This cross-sectional study included 63 children diagnosed with CLD at the National Liver Institute, Menoufia University, Egypt. Patients were categorized into H. pylori-positive and H. pylori-negative groups. All patients underwent gastrointestinal endoscopy, with histopathological examination and H. pylori stool antigen in stools. Demographic, clinical, laboratory, endoscopic, and histopathological findings were analyzed. Results: H. pylori-positive patients showed higher prevalence of abdominal pain, dyspepsia, anemia, melena, and hematemesis (P < 0.05). H. pylori infection was significantly associated with lower hemoglobin and elevated liver enzymes: ALT (89.3% vs. 62.9%, P = 0.000), AST (75% vs. 37.14%, P = 0.003), and total serum bilirubin (92.86% vs. 51.43%, P < 0.001). Endoscopic findings showed a significant association with gastritis (P = 0.007) and gastric nodularity (P = 0.006) in H. pylori-positive patient. A significantly higher infiltration of inflammatory cells and lymphoid follicle formation in both duodenal and gastric biopsies of H. pylori-positive patients. The need for intervention (sclerotherapy/banding) was significantly higher in H. pylori-positive patients. GBS was not statistically different between the two groups. Conclusion: H. pylori infection in children with CLD was associated with a higher prevalence of gastritis, gastric nodularity, and increased gastrointestinal bleeding symptoms with increased rates of sclerotherapy/banding in patient with CLD.