Background: The role of Helicobacter pylori in extragastrointestinal diseases, though not clearly established, is of great importance. Objectives: The study aims to evaluate the role of H. pylori infection in nonalcoholic fatty liver disease (NAFLD) and its association with NAFLD severity. Materials and methods: Thirty-six patients with biopsy-proven NAFLD (17 patients with simple nonalcoholic fatty liver and 19 patients with nonalcoholic steatohepatitis—NASH) and 23 healthy blood donors (control group) were included in the study. Serum samples were tested for H. pylori antibodies IgG, IgM, and IgA using enzyme-linked immunosorbent assay (ELISA). Parameters associated with metabolic syndrome were compared between H. pylori seropositive and seronegative patients in the NAFLD group. Seroprevalence and antibody titers of H. pylori in the NAFLD group were compared with the control group. Results: Anti-H. pylori IgG was positive in 22 (61%) cases of the NAFLD group and 13 (56%) cases of the control group. Anti-H. pylori IgM was positive in 4 (11%) cases of the NAFLD group and 2 (8%) cases of the control group. Anti-H. pylori IgA seroprevalence in the NAFLD group (n = 11; 31%) was higher than the control group (n = 4; 17%; p = 0.03). The NAFLD group had a higher anti-H. pylori IgA titer than the control group (p = 0.03). There were similar rates of anti-H. pylori IgG/IgM/IgA titers between NAFLD and NASH patients with no significant correlation between H. pylori infection and metabolic syndrome. Conclusion: An association of H. pylori infection was seen in NAFLD cases which might have a role in the pathogenesis of fatty liver diseases. This can be further explored for its exact role in the causation of fatty liver disease.
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