title: Relevance of underlying disease and bacterial vacA and cagA status on the efficacy of Helicobacter pylori eradication.
abstract: OBJECTIVE
  To study the effects of Helicobacter pylori associated diseases and the bacterial vacA and cagA statuses on the efficacy of H. pylori eradication.
  
  
  METHODS
  A prospective study in a consecutive series of outpatients of a gastroenterological institution and of a primary practice. A series of 146 H. pylori positive patients with peptic ulcer disease (PUD; n = 40) or nonulcer dyspepsia (NUD; n = 106) were evaluated. H. pylori vacA genotpyes and cagA status were determined directly in gastric biopsy specimens by polymerase chain reaction. The patients were treated with triple-therapy regimens consisting of a proton pump inhibitor and two antibiotics twice daily for 7 days. Reevaluation of H. pylori was determined 4-5 weeks later by endoscopy or 13C urea breath test.
  
  
  RESULTS
  123 patients completed the study. In 8 patients, colonization with two or more H. pylori strains was found. The overall cure rate was 84.6% (104/123). The eradication rates were significantly higher in patients with PUD (94.4%, 34/36) than in those with NUD (81.6%, 71/87; p < 0.05). In patients with cagA-positive H. pylori strains, the eradication rate was 89.0% (73/82) as compared with 78.8% (26/33) in those with cagA-negative strains (p = 0.15). The vacA genotype had no effect on the efficacy of H. pylori eradication.
  
  
  CONCLUSIONS
  Using 1-week triple-therapy regimens, treatment of H. pylori infection is more effective in patients with PUD than in those with NUD.
authors.affiliation: Department of Medicine, Division of Gastroenterology, University of Heidelberg, Germany. J.Rudi@t-online.de
authors.forename: Jochen
authors.initials: J
authors.lastname: Rudi
authors.forename: Susanne
authors.initials: S
authors.lastname: Reuther
authors.forename: Andreas
authors.initials: A
authors.lastname: Sieg
authors.forename: Martin
authors.initials: M
authors.lastname: Hoerner
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Stremmel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial; D001426:Bacterial Proteins / Q000378:metabolism*; D002352:Carrier Proteins / Q000378:metabolism*; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D004415:Dyspepsia / Q000382:microbiology*; D005260:Female; D005838:Genotype; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000235:genetics / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000382:microbiology*; D011446:Prospective Studies; D054328:Proton Pump Inhibitors
chemical_list: D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D002352:Carrier Proteins; D054328:Proton Pump Inhibitors; C074689:VacA protein, Helicobacter pylori; C080866:cagA protein, Helicobacter pylori