The effect of Helicobacter pylori eradication on C-reactive protein: results from a meta-analysis

INTRODUCTION: Helicobacter pylori is a bacterium that causes chronic gastroduodenal infection and affects various systemic diseases. An increase in the blood level of C-reactive protein (CRP; a systemic inflammatory marker), at a low-grade chronic inflammation level, is observed in cases of infection. However, the effect of H. pylori eradication on CRP remains undetermined. Therefore, we aimed to evaluate the circulating CRP levels in eradicated patients through a meta-analysis. MATERIAL AND METHODS: The PubMed database was searched from its inception to June 2020. Studies that described the CRP levels following H. pylori eradication were collected. A random-effects meta-analysis was then performed using inverse variance with standardized mean difference. RESULTS: A total of 10 eligible studies (642 subjects in total) were available. The median age in the studies was 49.9 years. The CRP level was 6.0 (median) mg/l before H. pylori eradication and 5.8 (median) mg/l after eradication. From the results of the overall meta-analysis, there was found to be a significant reduction in the CRP levels with H. pylori eradication (standardized mean difference: –0.64; 95% confidence interval: –1.02 to –0.27). The result was not similarly confirmed in a subanalysis of the available randomized controlled trials. CONCLUSIONS: Weak evidence exists regarding the effects of H. pylori eradication on CRP levels. Further research is called for.