S2084 Impact of H. pylori Treatment on the Incidence of Autoimmune, Metabolic, and Hematologic Conditions: A Retrospective Propensity-Matched Cohort Study

Introduction: Helicobacter pylori infection has been implicated in multiple systemic conditions, including autoimmune, metabolic, and nutritional disorders. However, the long-term impact of H. pylori eradication therapy on these outcomes remains unclear. Methods: A retrospective cohort study was conducted using the TriNetX database. Patients with a diagnosis of H. pylori infection were divided into 2 groups: treated (n = 35,565) and untreated (n = 35,565) after 1:1 propensity score matching. Baseline demographics were well balanced between groups (mean age 49.9 ± 17.2 years; 51.4% female). Outcomes were assessed over a 3-year follow-up period. Risk ratios (RR), 95% confidence intervals (CI), and P-values were calculated. Results: Following propensity score matching, 35,565 patients were included in each cohort. The mean age was 49.9 ± 17.2 years, with 51.4% identifying as female. Baseline demographics were well balanced between groups, with standardized differences for all covariates less than 0.01. The incidence of celiac disease was significantly lower in the treated group (RR 1.737; 95% CI: 1.166–2.588; P = 0.0060). Similarly, the risk of diabetes mellitus was reduced (RR 1.074; 95% CI: 1.035–1.114; P = 0.0001), as was the risk of autoimmune thyroiditis (RR 1.265; 95% CI: 1.021–1.570; P = 0.0322). Rheumatoid arthritis also occurred less frequently in the treated group (RR 1.485; 95% CI: 1.274–1.732; P < 0.0001). In addition, vitamin D deficiency was significantly less prevalent (RR 1.287; 95% CI: 1.227–1.350; P < 0.0001), and the combined outcome of chronic atrophic gastritis or vitamin B12 deficiency anemia was reduced (RR 1.374; 95% CI: 1.236–1.528; P < 0.0001). There was no significant difference between groups in the incidence of iron deficiency anemia (RR 0.975; 95% CI: 0.924–1.028; P = 0.3421). However, the risk of immune thrombocytopenic purpura was higher in the treated group (RR 0.715; 95% CI: 0.544–0.940; P = 0.0158). Conclusion: H. pylori eradication was linked to reduced risks of autoimmune, metabolic, and nutritional disorders, including celiac disease, diabetes, rheumatoid arthritis, thyroiditis, and vitamin D deficiency, but was associated with a slight increase in immune thrombocytopenia risk. These results highlight systemic benefits while underscoring the need for risk monitoring.