CagA-positive Helicobacter pylori infection is not associated with decreased risk of Barrett's esophagus in a population with high H. pylori infection rate.
OBJECTIVE
The role that H. pylori infection plays in the development of and Barrett's esophagus (BE) is uncertain. We tested the hypothesis that infection with cagA+ Helicobacter pylori strains protects against the development of BE.


METHODS
We studied 104 consecutive patients, residents in an area with a high prevalence of H. pylori infection, with BE and 213 sex- and age-matched controls. H. pylori infection and CagA antibody status were determined by western blot serology.


RESULTS
H. pylori prevalence was higher in patients with BE than in controls (87.5% vs. 74.6%; OR. 2.3; 95% CI: 1.23-4.59). Increasing age was associated with a higher prevalence of H. pylori (p < 0.05). The prevalence of CagA+ H. pylori serology was similar in patients with BE and controls (64.4% vs. 54.5%; NS). Type I H. pylori infection (CagA+ and VacA+) was similar in patients with BE and controls (44.2% vs. 41.3%; NS). Logistic regression analysis identified alcohol (O.R. 7.09; 95% CI 2.23-22.51), and H. pylori infection (OR: 2.41; 95%CI: 1.20-4.84) but not CagA+ serology as independent factors.


CONCLUSIONS
Neither H. pylori infection nor H. pylori infection by CagA+ strains reduce the risk of BE in a population with high prevalence of H. pylori infection.
Gastrointestinal Oncology Unit, Service of Digestive Diseases, Hospital Clínico Lozano Blesa, Zaragoza, Spain. aferrandeza@hotmail.com
Angel
A
Ferrández
Rafael
R
Benito
Juan
J
Arenas
María Asunción
MA
García-González
Federico
F
Sopeña
Javier
J
Alcedo
Javier
J
Ortego
Ricardo
R
Sainz
Angel
A
Lanas
D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking; D000942:Antigens, Bacterial / Q000097:blood*; D001426:Bacterial Proteins / Q000097:blood*; D001471:Barrett Esophagus / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D015153:Blotting, Western; D004724:Endoscopy; D005260:Female; D016481:Helicobacter Infections / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D016480:Helicobacter pylori; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking; D013030:Spain / Q000453:epidemiology
D000942:Antigens, Bacterial; D001426:Bacterial Proteins; C080866:cagA protein, Helicobacter pylori