{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:48:41Z","timestamp":1789778921865,"version":"4.0.1"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T00:00:00Z","timestamp":1652054400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004071","name":"Khon Kaen University","doi-asserted-by":"publisher","award":["RP64018"],"award-info":[{"award-number":["RP64018"]}],"id":[{"id":"10.13039\/501100004071","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Liver fluke infection caused by <jats:italic>Opisthorchis viverrini<\/jats:italic> is associated with several hepatobiliary diseases including advanced periductal fibrosis (APF) and cholangiocarcinoma. Recently, we demonstrated a persistent APF in over one\u2010third of opisthorchiasis patients after worm removal by praziquantel (PZQ) treatment. However, the underlying mechanism(s) of this phenomena is unclear. Given a co\u2010infection with <jats:italic>Helicobacter pylori<\/jats:italic> (<jats:italic>H. pylori<\/jats:italic>) especially <jats:italic>cagA<\/jats:italic>\u2010positive strain enhances APF, we hypothesized that <jats:italic>H. pylori<\/jats:italic> with CagA virulent factor contributes to persistent APF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Seventy\u2010five opisthorchiasis patients who underwent ultrasonography and treatment with PZQ were recruited in the 2\u2010year follow\u2010up study. <jats:italic>Helicobacter<\/jats:italic> and its cagA in the feces were examined by conventional and qPCR. Correlations between prevalence or bacterial loads of <jats:italic>Helicobacter<\/jats:italic> spp., <jats:italic>H. pylori<\/jats:italic>, and <jats:italic>cagA\u2010<\/jats:italic>positive <jats:italic>H. pylori<\/jats:italic> before and after PZQ treatment were analyzed among resolved, slowly resolved, relapsed, and persistent APF groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, prevalence of <jats:italic>Helicobacter<\/jats:italic> spp., <jats:italic>H. pylori<\/jats:italic>, and <jats:italic>cagA\u2010<\/jats:italic>positive <jats:italic>H. pylori<\/jats:italic> declined after PZQ treatment. However, only the prevalence and bacterial loads of <jats:italic>cagA\u2010<\/jats:italic>positive <jats:italic>H. pylori<\/jats:italic> detected at 2\u2010year post\u2010treatment were significantly lower than those before treatment (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). In addition, both prevalence and bacterial loads of <jats:italic>cagA\u2010<\/jats:italic>positive <jats:italic>H. pylori<\/jats:italic> were significantly lower in the resolved APF group after PZQ treatment, while there were no significant changes in the slowly resolved, relapsed, and persistent APF groups. Among the APF subgroups, <jats:italic>cagA<\/jats:italic>\u2010positive <jats:italic>H. pylori<\/jats:italic> prevalence in both relapsed and persistent APF groups were significantly higher than the resolved APF group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results support our hypothesis that <jats:italic>H. pylori<\/jats:italic>, especially <jats:italic>cagA<\/jats:italic>\u2010positive strain, contributes to the relapsed and persistent APF. A supplementary antibiotic treatment for <jats:italic>H. pylori<\/jats:italic> to reduce persistent APF and eventually CCA is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.12897","type":"journal-article","created":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T07:13:40Z","timestamp":1652080420000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Persistent advanced periductal fibrosis is associated with <i>cagA<\/i>\u2010positive <i>Helicobacter pylori<\/i> infection in post\u2010praziquantel treatment of opisthorchiasis"],"prefix":"10.1111","volume":"27","author":[{"given":"Hang Thi Thu","family":"Phung","sequence":"first","affiliation":[{"name":"Tropical Medicine Graduate Program, Faculty of Medicine Khon Kaen University  Khon Kaen Thailand"},{"name":"Tropical Disease Research Center, Faculty of Medicine Khon Kaen University  Khon Kaen Thailand"},{"name":"Department of Bacteriology National Institute 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Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences University of Liverpool  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8899-5919","authenticated-orcid":false,"given":"Banchob","family":"Sripa","sequence":"additional","affiliation":[{"name":"Tropical Disease Research Center, Faculty of Medicine Khon Kaen University  Khon Kaen Thailand"},{"name":"Department of Pathology, Faculty of Medicine Khon Kaen University  Khon Kaen 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