Association of Helicobacter pylori infection with chronic obstructive pulmonary disease and chronic bronchitis: a meta-analysis of 16 studies

Background: Chronic obstructive pulmonary disease (COPD) and chronic bronchitis (CB) are common respiratory diseases globally. The aim of this meta-analysis was to quantify the risk of these two diseases being associated with Helicobacter pylori infection. Methods: A literature search was performed to identify studies published before 5 June 2014 for relevant risk estimates. Fixed and random effect meta-analytical techniques were conducted for COPD and CB. Results: Sixteen observational studies involving 1390 patients with COPD, 734 with CB and more than 13 000 controls were included. Helicobacter pylori infection was associated with an increased risk of COPD and CB [odds ratio (OR) 2.07, 95% confidence interval (CI) 1.81 - 2.36, p for heterogeneity = 0.05; and OR 1.57, 95% CI 1.33-1.86, p for heterogeneity = 0.08]. We discovered a significant association between CagA-positive strains and risk for COPD (OR 3.46, 95% CI 2.29-5.25, p for heterogeneity = 0.20). Conclusions: Our meta-analysis suggested a potential relationship between H. pylori infection and the development of COPD and CB.