**5. Autoimmune diseases and liver steatosis**

Studies performed among patients with chronic viral autoimmune and toxic hepatitis and coexisting *H. pylori* infection demonstrated improvement in liver function, including decreased ALT and AST activity, after effective eradication of bacteria [26].

*H. pylori* infection is found in 20–50% of patients with AIH. Among patients with PBC, *H. pylori* infection is found more frequently than among people from the control group (54 vs. 31% p = 0.01). However, the effect of this infection on the course of PBC has not been elucidated [27].

Infection by these bacteria worsens the course of underlying disease; however, pathogenesis is not completely clear [28, 29]. In the group of patients with PBC and AIH, *H. pylori* infection may lead to precipitous, unfavorable progression of the disease [30].

Reports on the effect of *H. pylori* infection on lipid turnover disturbances, leading to hypertriglyceridemia and hypercholesterolemia with concomitant decrease of HDL level, are published more and more frequently. This is especially important for the metabolism of hepatocytes and their steatosis, as well as in the process of liver fibrosis [31]. Many reports point to the fact that *H. pylori* infection hastens the development of NAFLD [32]. It has been demonstrated that *H. pylori* infection among patients with NAFL results in the development of NASH. Eradication of the bacteria significantly facilitates the treatment of liver steatosis [33]. Moreover, it has been found that *H. pylori* infection and steatosis constitute the risk of more frequent occurrence of cholecystolithiasis and choledocholithiasis [34].
