S2124 H. pylori in Sickle Cell Disease: A Single Center Retrospective Study of Prevalence, Risk, and Outcomes

Introduction: Research is limited regarding the association between Helicobacter pylori infection and sickle cell disease (SCD). Further characterization of the SCD population’s H. pylori infection prevalence and susceptibility would be beneficial to our understanding of their risk and potential complications. This study aims to investigate the relationship between SCD and H. pylori infection in the adult population. Methods: We conducted a retrospective chart review of adult patients with SCD who presented to UIC between January 1, 2020 and March 31, 2024. The primary outcome was a diagnosis of H. pylori. Data collected includes variables such as demographics, genotype, regimen of H. pylori treatment, number of times treated, testing for cure, complications of SCD prior to diagnosis of H. pylori, medications prior to diagnosis of H. pylori, and complications related to infection. Statistical analysis was performed with Pearson Chi-Square, Fischer’s Exact Test, and odds ratio (OR) to compare categorical variables and risk. Results: Of 1,484 patients, 828 had sickle cell disease (SCD), with 85 (10%) testing positive for Helicobacter pylori (HP+). HP+ SCD patients were older (46.1 vs 38.9 years) and more often female (72%) compared to the overall SCD group. HP testing occurred in 30% of SCD patients, with a 5% positivity rate. Most HP+ SCD patients had HbSS (74%). Vaso-occlusive crises (VOC) were significantly more frequent in HP+ vs HP− patients (64% vs 42%, P = 0.015, OR 2.59). Other SCD complications did not differ significantly. Risk factor usage, including nonsteroidal anti-inflammatory drug and hydroxyurea, showed no statistical differences, though glucocorticoid use trended higher in HP+ patients (P = 0.086). Most SCD patients received 1 HP treatment, with triple therapy being most common (33%), followed by bismuth quadruple therapy (21%). gastroesophageal reflux disease was significantly more prevalent in non-SCD HP+ patients (50% vs 28%, P = 0.020), while other gastrointestinal complications were similar. Conclusion: Our findings suggest a notable association between H. pylori infection and vaso-occlusive crises in adults with sickle cell disease. Although overall H. pylori prevalence was low, infected individuals were older and predominantly female. The higher VOC rate highlights a potential clinical impact warranting further investigation. Routine screening for H. pylori in SCD patients with gastrointestinal symptoms may be beneficial in reducing complications.