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Research Article

JCDR. 2021; 12(6): 1259-1266

The Significance of Helicobacter Pylori Infection in the Aetiology of Minimum Hepatic Encephalopathy (MHE) and the Impact of its Eradication: A Prospective Clinical Study

Dr. Narendra Kumar, Dr. Vibha Sushilendu, Dr. Rajeev Kumar, Dr. Satish Kumar.


Aim: The aim of the study was to find the role of Helicobacter pylori infection in the
pathogenesis of minimal hepatic encephalopathy and effect of its eradication.
Methods: A prospective study was conducted in the Department of Medicine, Nalanda
Medical College and Hospital, Patna, Bihar, India, for 1 year. In patients of suspected
cirrhosis of liver ultrasound and endoscopic examination were performed. Those with
ultrasonographic findings of chronic liver disease and esophageal varices on endoscopic
examination were included in this study. Of the 165 patients with liver cirrhosis screened, 65
had one or more exclusion criterion; the study thus included 100 patients. Biochemical tests
and psychometric tests were performed initially on all patients included in the study.
Results: Based on results of the psychometric tests, 35 (53.8%) of the 65 patients with liver
cirrhosis had MHE. Clinical and demographic characteristics of the study patients are shown
in Table 2. Hepatitis B virus infection was the most common (36%) cause of cirrhosis. In the
study group, most patients were in Child-Pugh class A (25%) or B (58%); most patients in
Child-Pugh class C who were screened fulfilled one or more exclusion criteria. Presence of
MHE had no significant relationship with age, sex, Child-Pugh grade, and cause of cirrhosis.
H. Pylori infection was found in 42 (64.6%) of 65 patients with MHE and 13 (37.1%) of 35
patients without MHE (p< 0.001). Fasting blood ammonia level were significantly higher in
patients with MHE (1.65 [0.34] μg/mL) than in those without (1.06 [0.25] μg/mL; p

Key words: H. Pylori, hepatic encephalopathy, cirrhosis

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