The Association Between Helicobacter pylori Infection and Nonalcoholic Fatty Liver Disease

  • Derek M. Tang
  • Sheila KumarEmail author
Stomach and Duodenum (J Pisegna and J Benhammou, Section Editors))
Part of the following topical collections:
  1. Topical Collection on Stomach and Duodenum


Purpose of Review

Helicobacter pylori (HP) infection is known to be a significant risk factor in the development of certain gastric conditions, such as ulcers, gastritis, and malignancy. Recently, however, the systemic effect of HP infection on other organ systems has come to be appreciated. In this review, we will explore the association between HP infection and nonalcoholic fatty liver disease (NAFLD), the hepatic component of metabolic syndrome.

Recent Findings

The possible association between HP infection and NAFLD initially stemmed from the isolation of HP bacteria in the livers of patients with NAFLD. Although there have been conflicting results, several subsequent clinical trials have demonstrated a higher rate of fatty liver and NASH in HP-positive patients compared to HP-negative patients; in addition, small trials examining the effect of HP eradication have shown improvement in markers of NAFLD activity, further supporting a link between these two conditions. The pathophysiology behind the possible association between HP infection and NAFLD has yet to be fully elucidated; several possible mechanisms include induction of a pro-inflammatory state that shifts the body toward a more lipogenic profile, and a hormonal shift that favors progression toward insulin resistance and fibrosis.


The association between HP infection and NAFLD has been demonstrated in several clinical trials, including small trials evaluating the effect of HP eradication on NAFLD. Future studies examining the pathophysiology behind this association are the next step in characterizing the relationship between these two conditions.


Helicobacter pylori Nonalcoholic fatty liver disease Nonalcoholic steatohepatitis 


Compliance with Ethical Standards

Conflict of Interest

Sheila Kumar and Derek M. Tang declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media New York (outside the USA) 2017

Authors and Affiliations

  1. 1.Division of Gastroenterology, Southern California Permanente Medical GroupKaiser PermanenteAnaheimUSA
  2. 2.Digestive Diseases BranchNational Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of HealthBethesdaUSA

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