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Accumulating evidence indicates that persistent  Helicobacter pylori  gastric infection influences immune responses to oral enteric vaccines. We studied the association between pre-existing  H. pylori  serum IgG and serum pepsinogens levels (PGs) as markers of gastric inflammation and the immune response to single-dose live oral cholera vaccine CVD 103-HgR in Malian adults. Baseline sera obtained during a phase 2 safety/immunogenicity clinical trial of cholera vaccine CVD 103-HgR among 93 healthy Malian adults were tested for  H. pylori  IgG antibodies and PGI and PGII levels using enzyme linked immunosorbent assays. Overall 74/93 (80%) vaccine recipients were  H. pylori  IgG seropositive at baseline. Vibriocidal antibody seroconversion (≥ fourfold increase 14 days following administration of CVD 103-HgR compared to baseline) among vaccine recipients was 56%. However, vibriocidal antibody seroconversion was markedly higher among  H. pylori  seropositives than seronegatives 64% vs. 26% ( p  = 0.004); adjusted relative risk: 2.20 (95% confidence intervals 1.00–4.80;  p  = 0.049). Among  H. pylori  seropositive vaccine recipients, there were no significant associations between PGI, PGII and PGI:PGII levels and vibriocidal seroconversion. The enhanced seroconversion to oral cholera vaccine CVD 103-HgR among  H. pylori  seropositive African adults provides further evidence of the immunomodulating impact of  H. pylori  on oral vaccine immunogenicity.

Pre-existing Helicobacter pylori serum IgG enhances the vibriocidal antibody response to CVD 103-HgR live oral cholera vaccine in Malian adults