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Background:The 13C urea breath test (13C-UBT) is the gold standard for detecting Helicobacterpylori infection.H.pylori pathogenesis in patients with hepatitis B virus (HBV) and related diseases remains obscure.We used 13C-UBT to detect H.pylori infection in patients with chronic HBV infection,HBV-related cirrhosis,HBV-related hepatic carcinoma,and other chronic hepatic diseases.Methods:A total of 131 patients with chronic hepatitis B (HB),179 with HBV-related cirrhosis,103 with HBV-related hepatic carcinoma,45 with HBV-negative hepatic carcinoma,and 150 controls were tested for H.pylori infection using 13C-UBT.We compared H.pylori infection rate,liver function,complications of chronic hepatic disease,serum HBV-DNA,serum alpha-fetoprotein (AFP),and portal hypertensive gastropathy (PHG) incidence among groups.Results:HBV-related cirrhosis was associated with the highest H.pylori infection rate (79.3％).H.pylori infection rate in chronic HB was significantly higher than in the HBV-negative hepatic carcinoma and control groups (P ＜ 0.001).H.pylori infection rate in patients with HBV-DNA ≥103 copies/ml was significantly higher than in those with HBV-DNA ＜103 copies/ml (76.8％ vs.52.4％,P ＜ 0.001).Prothrombin time (21.3 ± 3.5 s vs.18.8 ± 4.3 s),total bilirubin (47.3±12.3 μmol/L vs.26.6 ±7.9 μmol/L),aspartate aminotransferase (184.5 ± 37.6 U/L vs.98.4 ± 23.5 U/L),blood ammonia (93.4 ± 43.6 μmol/L vs.35.5 ± 11.7 μmol/L),and AFP (203.4 ± 62.6 μg/L vs.113.2 ± 45.8 μg/L) in the 13C-UBT-positive group were significantly higher than in the 13C-UBT-negative group (P ＜ 0.01).The incidence rates of esophageal fundus variceal bleeding (25.4％ vs.16.0％),ascites (28.9％ vs.17.8％),and hepatic encephalopathy (24.8％ vs.13.4％) in the 13C-UBT-positive group were significantly higher than in the 13C-UBT-negative group (P ＜ 0.01).The percentages of patients with liver function in Child-Pugh Grade C (29.6％ vs.8.1％) and PHG (43.0％ vs.24.3％) in the 13C-UBT-positive group were significantly higher than in the 13C-UBT-negative group (P ＜ 0.05).Conclusions:It is possible that H.pylori infection could increase liver damage caused by HBV.H.pylori eradication should be performed in patients with complicating H.pylori infection to delay hepatic disease progression.