title: Case–control study of Epstein–Barr virus and  Helicobacter pylori serology in Latin  American patients with gastric disease.
abstract: BACKGROUND
  Chronic tissue damage induced by Helicobacter pylori (HP)-driven inflammation is considered the main risk of gastric carcinoma (GC). Epstein–Barr virus (EBV) infection has also been associated with GC. In this study, we aim to address the role of EBV in inflammatory GC precursor lesions and its added risk to HP infection.
  
  
  METHODS
  Antibodies against EBV, HP and the bacterial virulence factor CagA were measured in sera from 525 Mexican and Paraguayan patients with gastric disease. Gastric samples were characterised according to the updated Sydney classification and associations were estimated between antibody responses and severity of both tissue damage and inflammation.
  
  
  RESULTS
  We found significant associations (odd ratios and trends) between EBV and HP copositivity and premalignant lesions and intestinal-type GC. The EBV and HP coinfection was also significantly associated with increased infiltration of immune cells. No association was found between EBV and the less inflammation-driven diffuse-type GC.
  
  
  CONCLUSIONS
  Our study suggests that EBV co-participates with HP to induce severe inflammation, increasing the risk of progression to intestinal-type GC.
authors.affiliation: Unidad de Investigación Médica en Enfermedades Infecciosas y Parasitarias (UIMEIP), Hospital de Pediatría, CMN Siglo-XXI, Instituto Mexicano del Seguro Social (IMSS), Avenida Cuauhtémoc 330, Colonia Doctores, Delegación Cuauhtémoc, Ciudad de México, DF, CP 06720, México
authors.forename: M G
authors.initials: MG
authors.lastname: Cárdenas-Mondragón
authors.forename: J
authors.initials: J
authors.lastname: Torres
authors.forename: L
authors.initials: L
authors.lastname: Flores-Luna
authors.forename: M
authors.initials: M
authors.lastname: Camorlinga-Ponce
authors.forename: R
authors.initials: R
authors.lastname: Carreón-Talavera
authors.forename: A
authors.initials: A
authors.lastname: Gomez-Delgado
authors.forename: E
authors.initials: E
authors.lastname: Kasamatsu
authors.forename: E M
authors.initials: EM
authors.lastname: Fuentes-Pananá
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D020031:Epstein-Barr Virus Infections / Q000097:blood / Q000382:microbiology / Q000473:pathology* / Q000821:virology; D005260:Female; D005756:Gastritis / Q000097:blood / Q000382:microbiology / Q000473:pathology; D016481:Helicobacter Infections / Q000097:blood / Q000382:microbiology / Q000473:pathology* / Q000821:virology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D007843:Latin America; D008297:Male; D008800:Mexico; D008875:Middle Aged; D010239:Paraguay; D013272:Stomach Diseases / Q000097:blood* / Q000382:microbiology* / Q000473:pathology / Q000821:virology; D013274:Stomach Neoplasms / Q000097:blood / Q000382:microbiology / Q000473:pathology