title: Histological and endoscopic features of the stomachs of patients with Chagas disease in the era of Helicobacter pylori.
abstract: BACKGROUND
  Most studies that have evaluated the stomachs of patients with Chagas disease were performed before the discovery of Helicobacter pylori and used no control groups. This study compared the gastric features of chagasic and non-chagasic patients and assessed whether gastritis could be associated with Chagas disease.
  
  
  METHODS
  Gastric biopsy samples were taken from patients who underwent endoscopy for histological analysis according to the Updated Sydney System. H. pylori infection was assessed by histology, 16S ribosomal ribonucleic acid (rRNA) polymerase chain reaction (PCR), serology and the 13C-urea breath test. Patients were considered H. pylori-negative when all of these diagnostic tests were negative. Clinical and socio-demographic data were obtained by reviewing medical records and using a questionnaire.
  
  
  RESULTS
  The prevalence of H. pylori infection (70.3% versus 71.7%) and chronic gastritis (92.2% versus 85%) was similar in the chagasic and non-chagasic groups, respectively; such as peptic ulcer, atrophy and intestinal metaplasia. Gastritis was associated with H. pylori infection independent of Chagas disease in a log-binomial regression model. However, the chagasic H. pylori-negative patients showed a significantly higher grade of mononuclear (in the corpus) and polymorphonuclear (PMN) (in the antrum) cell infiltration. Additionally, the patients with the digestive form of Chagas disease showed a significantly lower prevalence of corpus atrophy than those with other clinical forms.
  
  
  CONCLUSIONS
  The prevalence of H. pylori infection and of gastric histological and endoscopic features was similar among the chagasic and non-chagasic patients. Additionally, this is the first controlled study to demonstrate that H. pylori is the major cause of gastritis in patients with Chagas disease.
authors: Instituto de Ciências Biológicas e Naturais, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil.
authors: Fernanda Machado
authors: FM
authors: Fonseca
authors: Serviço de Patologia Cirúrgica, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil.
authors: Renata Margarida
authors: RM
authors: Etchebehere
authors: Laboratório de Pesquisa em Bacteriologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, BRAZIL.
authors: Dulciene Maria de Magalhães
authors: DM
authors: Queiroz
authors: Laboratório de Pesquisa em Bacteriologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, BRAZIL.
authors: Andreia Maria Camargos
authors: AM
authors: Rocha
authors: Serviço de Endoscopia, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil.
authors: Iracema Saldanha
authors: IS
authors: Junqueira
authors: Serviço de Endoscopia, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil.
authors: Daurin Narciso da
authors: DN
authors: Fonseca
authors: Instituto de Ciências Biológicas e Naturais, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil.
authors: Aline Libério Braga
authors: AL
authors: Rodrigues
authors: Departamento de Clínica Médica, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil.
authors: Eduardo
authors: E
authors: Crema
authors: Instituto de Ciências Biológicas e Naturais, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil.
authors: Adriana Gonçalves
authors: AG
authors: de Oliveira
mesh_terms: D001706:Biopsy; D016022:Case-Control Studies; D014355:Chagas Disease / Q000150:complications / Q000382:microbiology / Q000473:pathology*; D005756:Gastritis / Q000150:complications / Q000382:microbiology / Q000473:pathology*; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000150:complications / Q000473:pathology*; D016480:Helicobacter pylori; D006801:Humans; D008875:Middle Aged; D015995:Prevalence