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Helicobacter pylori exposure reduces eosinophilic esophagitis risk

03 Feb 2019

Exposure to Helicobacter pylori appears to lower the risk of eosinophilic oesophagitis (EoE), according to a study. 

Researchers searched four large databases for comparative clinical studies with sufficient data to estimate the odds or risk of EoE (primary outcome) or oesophageal eosinophilia (secondary outcome) among individuals exposed to H. pylori (exposed) vs those who were tested negatively.

The meta-analysis included 11 observational studies involving 377,795 individuals worldwide. Data were pooled using random-effects model. Meta-regression and sensitivity analyses were planned a priori. Studies were individually assessed for quality, risk of bias, publication bias and heterogeneity.

Estimates showed that compared with nonexposure, H. pylori exposure was associated with a >30-percent decrease in the odds of EoE (odds ratio [OR], 0.63; 95 percent CI, 0.51–0.78) and of oesophageal eosinophilia (OR, 0.62; 0.52–0.76).

There were fewer prospective vs retrospective studies that reported a significant relationship between H. pylori exposure and EoE (p=0.06). Effect estimates were not altered by study location, whether the studies were conducted in paediatric or adult populations, time period (before vs after 2007), or prevalence of H. pylori in the study population.

Evidence has reported that previous or current infection with H. pylori protects against EoE, potentially due to infection-induced immunomodulation, researchers said. The present data lend support to this evidence, although more research is needed to determine the mechanisms of such a benefit.

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