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Background  Worldwide, there is a high co-endemicity of HIV and  H .  pylori  infection and there is growing evidence that  H .  pylori  co-infection is associated with parameters of HIV disease progression. The objective of this study was to investigate the prevalence of  H .  pylori  infection, and the association with clinical, immunological and virological parameters in a large cohort of HIV-infected individuals and uninfected controls in a West African country.    Methods  HIV-patients (n = 1,095) and HIV-negative individuals (n = 107) were recruited at a university hospital in Ghana.  H .  pylori  status was determined using stool antigen testing. HIV-related, clinical and socio-demographic parameters were recorded and analyzed according to  H .  pylori  status.    Results  The prevalence of  H .  pylori  infection was significantly lower in HIV-positive compared to HIV-negative individuals (51.5 vs. 88%, p<0.0001). In HIV patients,  H .  pylori  prevalence decreased in parallel with CD4+ T cell counts. In ART-naïve HIV-infected individuals, but not in those taking ART,  H .  pylori  infection was associated with higher CD4 cell counts (312 vs. 189 cells/μL, p<0.0001) and lower HIV-1 viral loads (4.92 vs. 5.21 log10 copies/mL, p = 0.006). The findings could not be explained by socio-demographic confounders or reported use of antibiotics. Having no access to tap water and higher CD4+ T cell counts were identified as risk factors for  H .  pylori  infection.    Conclusions    H .  pylori  prevalence was inversely correlated with the degree of immunosuppression. In ART-naïve individuals,  H .  pylori  infection is associated with favorable immunological and virological parameters. The underlying mechanisms for this association are unclear and warrant investigation.

Helicobacter pylori Infection Is Associated with Higher CD4 T Cell Counts and Lower HIV-1 Viral Loads in ART-Naïve HIV-Positive Patients in Ghana