H. Pylori and HIV: What Do I Need to Know? (Editor's Pick)

Question

Hi Nelson,

Are you familiar at all with H Pylori? My partner and I both positive, we work out hard, have fairly lean bodies, but both have rather large guts. I have assumed that this was related to the antivirals we have been using. But recently our doctor suggested examining us for H Pylori? He said it is rather common, but left untreated could result in stomach ulcers.

Well, we were tested and both came up positive for H Pylori.

Unexpected side effect of the two week treatment - major loss of the large "gut" we were both exhibiting? Interesting. Any thoughts here?

Answer

I am very familiar with H. Pylori. I was diagnosed with it using a urea breath test 2 years ago when I was diagnosed with lymphoma on the stomach wall. This was caused by immune activation caused by this bug. I had to go through 4 different multi-antibiotic cocktails before killing it (I was found to have drug resistant H. Pylori).

Up to 85% of people infected with H. pylori never experience symptoms or complications. Acute infection may appear as an acute gastritis with abdominal pain (stomach ache) or nausea. Where this develops into chronic gastritis, the symptoms, if present, are often those of non-ulcer dyspepsia: stomach pains, nausea, bloating, belching, and sometimes vomiting or black stool.

Individuals infected with H. pylori have a 10 to 20% lifetime risk of developing peptic ulcers and a 1 to 2% risk of acquiring stomach cancer. Inflammation caused by this pathogen is more likely to lead to duodenal ulcers, gastric ulcers and gastric carcinoma. A meta-analysis conducted in 2009 concluded the eradication of H. pylori reduces gastric cancer risk in previously infected individuals, suggesting the continued presence of H. pylori constitutes a relative risk factor of 65% for gastric cancers; in terms of absolute risk, the increase was from 1.1% to 1.7%. I presume that those of us living with HIV for a long time with CD4 cells under 300 may be at higher risks of these issues.

I would get an urea breath test to ensure you do not have it. Since I had a strange sensation in my stomach, I urged my doctor to send me to an upper GI endoscopy in which they took samples of my stomach lining. H. Pylori was found even after my first round of antibiotics and stage 1 lymphoma was detected. Luckily, I eventually overcame both. It was not a fun 6 months of my life (2013).

Bodybuilder belly

I hope this did not scare you. I am just sharing my experience.

In health,

Nelson