BACKGROUND:
Hepatitis B virus (HBV) is a major global public health issue and the most common etiology of chronic liver disease (CLD). The connection between Helicobacter pylori and patients who are HBsAg positive has not been thoroughly explored and has generated considerable scientific and clinical curiosity, although the debate persists.

OBJECTIVE:
This study aimed to assess serological and virological characteristics of HBsAg+ liver disease patients with and without H. pylori infection.

METHODS:
From April 1, 2021, to March 30, 2022, a hospital-based cross-sectional study was conducted at the University of Gondar Comprehensive Specialized Hospital on 384 known HBsAg+ liver disease patients recruited using a convenience sampling technique. All the 384 HBsAg+ patients were tested for fecal H. pylori antigen. For HBeAg, HBeAb, and HBV-DNA analysis, we recruited only 50 subsamples randomly. Serological tests were performed using commercially available enzyme immunoassay Architect System kits. For virological investigations, HBV-DNA was extracted using the Abbott mSample Preparation System DNA, and then HBV viral load was determined by real-time PCR. GraphPad Prism 8.02 and SPSS 25 were used for data analysis, considering a statistically significant P-value of 0.05.

RESULTS:
H. pylori co-infection was found in 153 (39.8%) of HBsAg+ study participants. The prevalence of HBeAg (5/25) and HBV-DNA (15/25) was higher among the H. pylori co-infected patient group, whereas HBeAb prevalence (11/25) was lower in the co-infected group. The levels of HBeAg (p<0.04), HBeAb (p<0.01), and HBV viral load (p<0.006) were increased in H. pylori co-infected patients than in HBV mono-infected patients.

CONCLUSIONS:
HBeAg and HBV-viral load were higher in H. pylori co-infected HBsAg+ patients. These findings suggested that H. pylori has a role in the increment of clinical, serological, and virological parameters in HBsAg+ liver diseases.