Pilot Award Recipient: Megan O'Brien

The advent of effective antiretroviral therapy (ART) has led to tremendous improvement in the health, survival, and quality of life of people living with HIV (PWH). However, PWH continue to experience an elevated risk of non-AIDS comorbidities, which have been associated with chronic inflammation and which persist, even with effective viral suppression. Chronic coinfections have been implicated as an important contributor to ongoing chronic inflammation and premature aging among PWH.

This cross-sectional pilot study will measure the prevalence of Helicobacter pylori and its association with chronic inflammatory markers among a sample of 75 adult PWH in the DC Cohort, a longitudinal cohort of approximately 6,500 PWH actively in care across 14 outpatient clinics in Washington, DC.

H. pylori is a chronic bacterial infection typically acquired during childhood that is estimated to affect approximately 30-40% of adults in the United States (US) and is associated with chronic inflammation and a range of inflammation-related comorbidities. H. pylori is typically treated with a short course of antibiotics and effective treatment has been associated with a reduction in chronic inflammatory markers. However, there has been limited research on H. pylori coinfection among PWH in the US and whether screening and treatment may provide an avenue for reducing chronic inflammation and associated comorbidities among PWH.

The  pilot study is designed to gather preliminary data about the burden of H. pylori coinfection among PWH in Washington, DC and differences in inflammatory markers between individuals with and without H. pylori. H. pylori infection will be diagnosed with a urea breath test and inflammatory markers will be measured from blood samples. Participants will also complete a brief questionnaire about current symptoms and medication use, childhood setting and conditions, basic demographics, and potential confounders (including other infections, smoking, and alcohol use). These data will be used to develop a future R01 funding proposal for additional studies in a larger group of individuals to generate evidence needed to understand the potential role that H. pylori screening and treatment could play to reduce inflammation-associated comorbidities among PWH.

Project Summary provided by investigator.