Helicobacter pylori Infection Is Not Associated With Portal Hypertension-Related Gastrointestinal Complications: A Meta-Analysis.

Background/Aims Despite the importance of Helicobacter pylori infection and portal hypertension (P_H)-associated gastrointestinal (GI) diseases such as esophageal varices and portal hypertensive gastropathy (P_HG), the impact of H. pylori infection on P_H-related GI complications had not been fully understood. This meta-analysis was performed to summarize articles that estimate the association of H. pylori infection with the risk of P_H-related GI complications. Methods An electronic search for original articles published before December 2018 was performed using PubMed, Embase, and Cochrane Library. Results A total of 802 cases of H. pylori infection and 776 uninfected controls were included from nine studies. H. pylori infection had no significant association with esophageal varix (relative risk [RR], 0.96; 95% confidence interval [CI], 0.86 to 1.07 for the all selected studies; RR, 0.94; 95% CI, 0.82 to 1.09 for the cohort studies; odds ratio [OR], 0.96; 95% CI, 0.60 to 1.54 for the case-control studies). Although H. pylori infection was significantly associated with P_HG in the case-control studies (OR, 2.22; 95% CI, 1.30 to 3.79), no significant differences were found in the cohort studies (RR, 0.98; 95% CI, 0.90 to 1.07), or any of the studies (RR, 1.02; 95% CI, 0.94 to 1.10). Heterogeneity in any meta-analysis was no found (P_H>0.10), and publication bias assessed by Begg's test and Egger's test was unremarkable. Conclusions H. pylori infection is not associated with the risk of P_H-related GI complications. This date can be used in the development of treatment strategies for P_H-related GI complications in patients with cirrhosis. [ABSTRACT FROM AUTHOR]