Helicobacter pylori density and cagA status in cirrhotic patients: a case-control study.
OBJECTIVE
Despite a similar Helicobacter pylori prevalence, peptic ulcer is more frequent in cirrhotic patients than in controls. We evaluated whether cirrhotic patients had an increased bacterial density and/or a higher prevalence of H. pylori cagA-positive strains than controls.


METHODS
A total of 36 dyspeptic cirrhotic patients with H. pylori infection and 72 matched controls were enrolled. H. pylori infection was detected at histology on Giemsa staining, bacterial density was assessed using difference over baseline (DOB) values at 13C urea breath test, and cagA status was established at serology.


RESULTS
Overall, both DOB values and prevalence of cagA did not significantly differ between cirrhotic patients and controls. However, peptic ulcer controls showed significantly higher DOB value (27.9 +/- 17.4 vs 19.4 +/- 9.3, respectively; P = 0.009) and cagA positive rate (85%vs 48%; P = 0.01) than non-ulcer dyspepsia patients. Although not statistically significant, a similar trend was observed in cirrhotic patients with peptic ulcer for DOB values (26.5 +/- 16.3 vs 18.3/1000 +/- 9.2, respectively; P = 0.07), whereas the cagA-positive rate was similar between peptic ulcer and non-ulcer dyspepsia patients (60%vs 50%; P = 0.30).


CONCLUSIONS
The present data showed that both bacterial density and cagA prevalence did not differ between cirrhotic patients and controls.
Zullo
Angelo
A
Gastroenterology and Digestive Endoscopy, Nuovo Regina Margherita Hospital, Rome, Italy. zullo66@yahoo.it
Sanchez-Mete
Lupe
L
Hassan
Cesare
C
Diana
Fabio
F
Festuccia
Federica
F
Attili
Adolfo Francesco
AF
Morini
Sergio
S
D000368:Aged; D000942:Antigens, Bacterial / Q000096:biosynthesis*; D001426:Bacterial Proteins / Q000096:biosynthesis*; D016022:Case-Control Studies; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000453:epidemiology / Q000378:metabolism*; D016480:Helicobacter pylori / Q000472:pathogenicity*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000150:complications / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000453:epidemiology / Q000382:microbiology*; D015995:Prevalence
D000942:Antigens, Bacterial; D001426:Bacterial Proteins; C080866:cagA protein, Helicobacter pylori