463. Incidence and Treatment Outcomes of Helicobacter Pylori Infection in HIV-Infected Patients, in a Large AIDS Center in New York City
Session: Poster Abstract Session: HIV Primary Care
Friday, October 21, 2011
Room: Poster Hall B1
Background: Gastrointestinal symptoms are frequent in HIV-infected patients with Helicobacter pylori infection being a common cause of gastritis and peptic ulcer disease.

Methods: A retrospective chart review of 4918 HIV-infected patients was performed from 1/1/2004 to 12/31/2010.  169 patients were diagnosed with H. pylori infection: 150 with positive serology, 12 with stool antigen, 7 with incidental positive histology on upper endoscopy (EGD).   Demographic data, EGD findings, and pathology were analyzed as well as treatment options and outcomes.

Results: The incidence of H. pylori infection was 169/4918, 3.4%.  Characteristics of the cohort: 106 men (62.7%).  Median Age: 46 (19-71).  Median CD4: 429/µL (2-1486). Only 22 patients had CD4 ≤ 200. 104 patients had undetectable HIV viral load. Median HIV viral load was log104.08.  Race: 70/169 (41.4%) African American, 85/169 (50.2%) Hispanic, 13/169 (7.69%) Caucasian, 1/169 Asian. HIV risk factors: Heterosexual 44%, MSM 38%, intravenous drug abuse 17%, 1% blood transfusion.  49 patients had hepatitis C.   77% were on HAART.  46 patients had history of incarceration. 48 patients had EGD; 27 with positive pathology, 15 were done after treatment with negative pathology.  64 patients were born outside the United States (US) (78% from Latin America/Caribbean, 16% Africa, 3% Asia). 15 patients had traveled to endemic regions.  129 patients were treated.  Amoxicillin-Clarithromycin (CL)-Proton pump inhibitor (PPI) combination was used in 113 patients.  8 patients used Bismuth-Metronidazole (ME)-Tetracycline (TE), 3 CL-ME-PPI, 2 CL-TE-PPI, 2 Levofloxacin based-PPI.  8 patients were retreated (4 with same, 4 with different therapy) due to primary failure.  At end of follow up, there were 121 patients cured-11 with negative stool antigen, 15 by histology and the rest by resolution of symptoms.  4 patients remained symptomatic, 1 had persistent positive stool antigen after 2 treatments but remained asymptomatic, and 3 were lost to follow up.

Conclusion: Incidence of H. pylori infection in our New York clinic was common and was more prevalent in HIV infected patients with CD4>200.  Treatment failure was uncommon.  Birth outside US, Hispanic race, incarceration and travel to endemic region were common risk factors for infection.


Subject Category: H. HIV/AIDS and other retroviruses

Cristina Batog, MD1, George Jr Psevdos, MD2, Joyce Park3 and Victoria Sharp, MD2, (1)Infectious Disease, St. Luke's Roosevelt Hospital, New York, NY, (2)Center for Comprehensive Care, St.Luke's-Roosevelt Hospital Center, New York, NY, (3)Center for Comprehensive Care, New York, NY

Disclosures:

C. Batog, None

G. J. Psevdos, None

J. Park, None

V. Sharp, None

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