Human immunodeficiency virus and Helicobacter pylori coinfection: Immune modulation and eradication failure.

This article focuses on the complex bidirectional relationship between Human Immunodeficiency Virus (HIV) and Helicobacter pylori (H. pylori) co-infection, highlighting their mutual immune modulation and clinical implications. H. pylori infection can inhibit HIV invasion of CD4+ cells and reactivate latent HIV, while HIV infection reduces pro-inflammatory cytokine secretion, leading to decreased H. pylori-induced gastric pathology. Treatment of both infections simultaneously is recommended to reduce mutual immune activation; however, people living with HIV (PLWH) exhibit higher rates of antibiotic resistance to common H. pylori therapies, complicating eradication efforts. The article underscores the need for antimicrobial susceptibility testing and tailored treatment guidelines for managing H. pylori in PLWH, given the frequent use of multiple antibiotics and the risk of resistance.