Prevalence of Helicobacter pylori and cytotoxin-associated gene A in Iranian patients with non-erosive and erosive reflux disease.
BACKGROUND
The prevalence of Helicobacter pylori (H. pylori) infection and its virulent strain (cytotoxin-associated gene A: CagA) has not been evaluated in patients with gastroesophageal reflux disease (GERD) subgroups (erosive and non-erosive) in Iran.


OBJECTIVE
This study was conducted to evaluate H. pylori infection and anti-CagA status in GERD.


METHODS
One hundred fifty-four patients (71 male and 83 female; mean age, 42.6+/- 15.5 years) were evaluated for symptoms--heartburn and acid regurgitation--compatible with GERD.


METHODS
The esophagus was diagnosed endoscopically whether it was with erosion (erosive reflux disease, ERD) or without erosion (non-erosive reflux disease, NERD). Rates of anti-H. pylori and anti-CagA-IgG (immunoglobulin G) antibodies were determined for each subject by ELISA. H. pylori was considered by ELISA if the rapid urease test proved positive.


METHODS
anti-H. pylori and anti-CagA statuses were compared in ERD and NERD patients with and without related IgG antibodies. Mean values and P values were calculated using SPSS (version 12).


RESULTS
The overall prevalence of H. pylori infection was 75.3% (116/154). Anti-CagA antibody was found in 60.3% (70/116) of infected patients. The prevalence of H. pylori infection in patients with NERD and ERD was 81.2% (56/69) and 70.6% (60/85), respectively (OR=0.56; 95% CI [confidence interval]=0.26-1.20; P=.14). The prevalence of anti-CagA antibody in infected NERD and ERD patients was 58.9% (33/56) and 61.7% (37/60), respectively (OR=1.16; 95% CI=0.49-1.70; P=0.83).


CONCLUSIONS
The results showed that more than 70% of the patients, either NERD or ERD, acquire H. pylori infection. Anti-CagA antibody is also common in patients with reflux disorders in our community.
Rasmi
Yousef
Y
Department of Biochemistry, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran. rasmiy@umsu.ac.ir
Sadreddini
Masoud
M
Shahsavari
Zahra
Z
Raeisi
Sina
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D000942:Antigens, Bacterial / Q000235:genetics* / Q000276:immunology; D001426:Bacterial Proteins / Q000235:genetics* / Q000276:immunology; D001427:Bacterial Toxins / Q000235:genetics* / Q000276:immunology; D015992:Body Mass Index; D016001:Confidence Intervals; D003603:Cytotoxins / Q000235:genetics* / Q000276:immunology; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011795:Surveys and Questionnaires; D055815:Young Adult
D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D001427:Bacterial Toxins; D003603:Cytotoxins; D007074:Immunoglobulin G; C080866:cagA protein, Helicobacter pylori