Histopathological Spectrum and Clinicopathological Correlates of ‎Helicobacter pylori–Associated Gastritis in Western Libya: A ‎Retrospective Cross-Sectional Study

Purpose: To delineate the histopathological spectrum of Helicobacter pylori associated gastritis, describe its clinicodemographic correlates, and determine the prevalence and severity patterns of infection among patients undergoing endoscopic gastric biopsy in western Libya.

Materials and Methods: A retrospective cross-sectional analysis was conducted on 136 histopathological specimens received between January 2025 and June 2026. Demographic, clinical, endoscopic, and histological data were extracted from laboratory records. H. pylori positivity was established histologically on hematoxylin and eosin staining. Descriptive statistics, chi-square tests, and the Mann Whitney U test were applied, with significance set at p < 0.05.

Results: Gastric biopsies accounted for 47.8% (n = 65) of all specimens. H. pylori was identified in 81.5% (n = 53; 95% CI: 70.4%–89.1%) of these biopsies. Infected patients were predominantly female (60.4%) with a mean age of 38.0 ± 15.1 years (range 17–76). Moderate chronic active gastritis predominated (64.2%), followed by severe (20.8%) and mild (13.2%) grades. Pangastritis was the commonest endoscopic pattern (39.6%). No significant association was found between infection and gender (χ² = 0.000, p = 1.000) or age (U = 235.000, p = 0.331), nor did severity differ by sex (χ² = 1.300, p = 0.522).

Conclusion: H. pylori infection is highly prevalent among biopsy-referred patients and most often presents as moderate chronic active gastritis. The absence of gender or age predisposition reflects the indiscriminate nature of the pathogen. Routine histopathological assessment of gastric biopsies remains essential for diagnosis, severity stratification, and gastric cancer risk assessment. (Open J Biomed Res 2026;5:102-113)