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Here, 553 age-sex matched cases and controls, 293 and 260 positive and negative for liver fluke <jats:italic>O. viverrini<\/jats:italic> eggs, of residents in Northeastern Thailand were investigated for associations among infection with liver fluke, <jats:italic>Helicobacter<\/jats:italic> and hepatobiliary fibrosis. The prevalence of <jats:italic>H. pylori<\/jats:italic> infection was higher in <jats:italic>O. viverrini<\/jats:italic>-infected than uninfected participants. <jats:italic>H. pylori<\/jats:italic> bacterial load correlated positively with intensity of <jats:italic>O. viverrini<\/jats:italic> infection, and participants with opisthorchiasis exhibited higher frequency of virulent <jats:italic>cag<\/jats:italic>A-positive <jats:italic>H. pylori<\/jats:italic> than those free of fluke infection. Genotyping of <jats:italic>cagA<\/jats:italic> from feces of both infected and uninfected participants revealed that the AB genotype accounted for 78% and Western type 22%. Participants infected with <jats:italic>O. viverrini<\/jats:italic> exhibited higher prevalence of typical Western type (EPIYA ABC) and variant AB\u2019C type (EPIYT B) CagA. Multivariate analyses among <jats:italic>H. pylori<\/jats:italic> virulence genes and severity of hepatobiliary disease revealed positive correlations between biliary periductal fibrosis during opisthorchiasis and CagA and CagA with CagA multimerization (CM) sequence-positive <jats:italic>H. pylori<\/jats:italic>. These findings support the hypothesis that <jats:italic>H. pylori<\/jats:italic> contributes to the pathogenesis of chronic opisthorchiasis and specifically to opisthorchiasis-associated CCA.<\/jats:p>","DOI":"10.1038\/srep42744","type":"journal-article","created":{"date-parts":[[2017,2,15]],"date-time":"2017-02-15T11:37:13Z","timestamp":1487158633000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":57,"title":["Elevated prevalence of Helicobacter species and virulence factors in opisthorchiasis and associated hepatobiliary disease"],"prefix":"10.1038","volume":"7","author":[{"given":"Raksawan","family":"Deenonpoe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eimorn","family":"Mairiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pisaln","family":"Mairiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chawalit","family":"Pairojkul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaovalux","family":"Chamgramol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Rinaldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Loukas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul J.","family":"Brindley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Banchob","family":"Sripa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2017,2,15]]},"reference":[{"key":"BFsrep42744_CR1","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.1016\/j.ijpara.2013.07.007","volume":"43","author":"TN Petney","year":"2013","unstructured":"Petney, T. 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