• 1.

    Righetti AA, Koua AYG, Adiossan LG, Glinz D, Hurrell RF, N'goran EK, Niamké S, Wegmüller R, Utzinger J, 2012. Etiology of anemia among infants, school-aged children, and young non-pregnant women in different settings of South-Central Côte d'Ivoire. Am J Trop Med Hyg 87: 425434.

    • Search Google Scholar
    • Export Citation
  • 2.

    Suerbaum S, Michetti P, 2002. Helicobacter pylori infection. N Engl J Med 347: 11751186.

  • 3.

    Cardenas VM, Mulla ZD, Ortiz M, Graham DY, 2006. Iron deficiency and Helicobacter pylori infection in the United States. Am J Epidemiol 163: 127134.

    • Search Google Scholar
    • Export Citation
  • 4.

    Baggett HC, Parkinson AJ, Muth PT, Gold BD, Gessner BD, 2006. Endemic iron deficiency associated with Helicobacter pylori infection among school-aged children in Alaska. Pediatrics 117: e396e404.

    • Search Google Scholar
    • Export Citation
  • 5.

    Fagan RP, Dunaway CE, Bruden DL, Parkinson AJ, Gessner BD, 2009. Controlled, household-randomized, open-label trial of the effect of treatment of Helicobacter pylori infection on iron deficiency among children in rural Alaska: results at 40 months. J Infect Dis 199: 652660.

    • Search Google Scholar
    • Export Citation
  • 6.

    Muhsen K, Barak M, Henig C, Alpert G, Ornoy A, Cohen D, 2010. Is the association between Helicobacter pylori infection and anemia age dependent? Helicobacter 15: 467472.

    • Search Google Scholar
    • Export Citation
  • 7.

    Muhsen K, Barak M, Shifnaidel L, Nir A, Bassal R, Cohen D, 2009. Helicobacter pylori infection is associated with low serum ferritin levels in Israeli Arab children: a seroepidemiologic study. J Pediatr Gastroenterol Nutr 49: 262264.

    • Search Google Scholar
    • Export Citation
  • 8.

    Muhsen K, Cohen D, 2008. Helicobacter pylori infection and iron stores: a systematic review and meta-analysis. Helicobacter 13: 323340.

 
 
 
 

 

 
 
 

 

 

 

 

 

 

Helicobacter pylori Infection and Anemia

View More View Less
  • 1 Center for Vaccine Development
  • | 2 University of Maryland School of Medicine
  • | 3 Baltimore, Maryland
  • | 4 E-mail: kmuhsen@medicine.umaryland.edu
  • | 5 Department of Epidemiology and Preventive Medicine
  • | 6 School of Public Health
  • | 7 Sackler Faculty of Medicine
  • | 8 Tel Aviv University
  • | 9 Tel Aviv, Israel
  • | 10 E-mail: dancohen@post.tau.ac.il

Dear Sir:

In their comprehensive and rigorous study on the etiology of anemia in Côte d'Ivoire, Righetti and others1 reported high prevalence of anemia (45–75%), inflammation, and deficiencies of iron, riboflavin, and vitamin A. The factors that were significantly and positively linked to the prevalence of anemia differed by age group: (1) infection with Plasmodium falciparum in 6- to 23-month-old children, (2) cellular iron deficiency and chronic inflammation in 6- to 8-year-old children, and (3) cellular iron deficiency in non-pregnant young women.1 Identifying modifiable risk factors like the factors reported by Righetti and others1 is highly important and can help in establishing interventions aimed at reducing the burden of anemia.

Helicobacter pylori colonizes the stomach; typically, it is acquired in childhood and causes asymptomatic chronic infection, which is highly endemic in developing countries.2 A small portion of H. pylori-infected subjects develop peptic ulcers and gastric carcinoma, usually in late adulthood.2 In well-designed studies, H. pylori was found to be associated with increased likelihood of iron deficiency anemia (IDA)3,4; furthermore, anti-H. pylori therapy substantially reduced the percentage of children affected with IDA.5 In a community-based study among Arab children in Israel, we found significantly lower mean hemoglobin levels in children ages 6–9 years who were infected with H. pylori compared with their uninfected peers.6 H. pylori was also associated with low ferritin levels.6,7 In a systematic review and meta-analysis,8 we found higher prevalence of IDA in H. pylori-infected subjects than uninfected ones (pooled odds ratio = 2.8; 95% confidence interval = 1.9–4.2).8

We recommend the investigation of H. pylori infection as a potential factor that might play a role in the occurrence of anemia in this population.1 Trials on the impact of anti-H. pylori therapy on the burden of anemia and IDA could shed light on whether the association between H. pylori and these disorders is causal.

  • 1.

    Righetti AA, Koua AYG, Adiossan LG, Glinz D, Hurrell RF, N'goran EK, Niamké S, Wegmüller R, Utzinger J, 2012. Etiology of anemia among infants, school-aged children, and young non-pregnant women in different settings of South-Central Côte d'Ivoire. Am J Trop Med Hyg 87: 425434.

    • Search Google Scholar
    • Export Citation
  • 2.

    Suerbaum S, Michetti P, 2002. Helicobacter pylori infection. N Engl J Med 347: 11751186.

  • 3.

    Cardenas VM, Mulla ZD, Ortiz M, Graham DY, 2006. Iron deficiency and Helicobacter pylori infection in the United States. Am J Epidemiol 163: 127134.

    • Search Google Scholar
    • Export Citation
  • 4.

    Baggett HC, Parkinson AJ, Muth PT, Gold BD, Gessner BD, 2006. Endemic iron deficiency associated with Helicobacter pylori infection among school-aged children in Alaska. Pediatrics 117: e396e404.

    • Search Google Scholar
    • Export Citation
  • 5.

    Fagan RP, Dunaway CE, Bruden DL, Parkinson AJ, Gessner BD, 2009. Controlled, household-randomized, open-label trial of the effect of treatment of Helicobacter pylori infection on iron deficiency among children in rural Alaska: results at 40 months. J Infect Dis 199: 652660.

    • Search Google Scholar
    • Export Citation
  • 6.

    Muhsen K, Barak M, Henig C, Alpert G, Ornoy A, Cohen D, 2010. Is the association between Helicobacter pylori infection and anemia age dependent? Helicobacter 15: 467472.

    • Search Google Scholar
    • Export Citation
  • 7.

    Muhsen K, Barak M, Shifnaidel L, Nir A, Bassal R, Cohen D, 2009. Helicobacter pylori infection is associated with low serum ferritin levels in Israeli Arab children: a seroepidemiologic study. J Pediatr Gastroenterol Nutr 49: 262264.

    • Search Google Scholar
    • Export Citation
  • 8.

    Muhsen K, Cohen D, 2008. Helicobacter pylori infection and iron stores: a systematic review and meta-analysis. Helicobacter 13: 323340.

Save