title: Clinical Manifestations of Helicobacter pylori-Negative Gastritis.
abstract: OBJECTIVE
  There are data to suggest the existence of non-Helicobacter pylori gastritis. However, the risk factors and clinical course for H pylori-negative gastritis remain unclear. We aimed to examine the prevalence and determinants of H pylori-negative gastritis in a large multiethnic clinical population.
  
  
  METHODS
  We conducted a cross-sectional study among patents scheduled for an elective esophagastroduodenoscopy or attending selected primary care clinics and eligible for screening colonoscopy at a single Veterans Affairs medical center. We identified cases of H pylor-negative gastritis, H pylori-positive gastritis, and H pylori-negative nongastritis, where gastritis was defined by the presence of neutrophils and/or mononuclear cells. Risk factors for H pylori-negative gastritis were analyzed in logistic regression models.
  
  
  RESULTS
  A total of 1240 patients had information from all biopsy sites, of whom 695 (56.0%) had gastritis. H pylori-negative gastritis was present in 123 patients (9.9% of all study subjects and 17.7% of all patients with gastritis). Among all patients with gastritis, African Americans were statistically significantly less likely than non-Hispanic whites to have H pylori-negative gastritis (odds ratio, 0.25; 95% confidence interval, 0.14-0.43). Conversely, PPI users were more likely to have H pylori-negative gastritis than H pylori-positive gastritis compared with nonusers (odds ratio, 2.02; 95% confidence interval, 1.17-3.49). The cumulative incidence of gastric erosions and ulcers were higher in patients with H pylori-negative gastritis than H pylori-negative nongastritis.
  
  
  CONCLUSIONS
  We found that H pylori-negative gastritis was present in approximately 18% of patients with gastritis. The potential for H pylori-negative gastritis to progress or the risk of gastric cancer of those with gastric mucosal atrophy/intestinal metaplasia remains unclear.
authors.affiliation: Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center, Houston, Texas; Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas.
authors.forename: Seiji
authors.initials: S
authors.lastname: Shiota
authors.affiliation: Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas; Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas.
authors.forename: Aaron P
authors.initials: AP
authors.lastname: Thrift
authors.affiliation: Department of Pathology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas.
authors.forename: Linda
authors.initials: L
authors.lastname: Green
authors.affiliation: Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center, Houston, Texas; Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Shah
authors.affiliation: Department of Pathology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas.
authors.forename: Gordana
authors.initials: G
authors.lastname: Verstovsek
authors.affiliation: Surgical Pathology & Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy; Casa Sollievo della Sofferenza, Department of Pathology, San Giovanni Rotondo, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Rugge
authors.affiliation: Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center, Houston, Texas; Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas.
authors.forename: David Y
authors.initials: DY
authors.lastname: Graham
authors.affiliation: Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center, Houston, Texas; Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas; Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, Texas. Electronic address: hasheme@bcm.edu.
authors.forename: Hashem B
authors.initials: HB
authors.lastname: El-Serag
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D005756:Gastritis / Q000453:epidemiology* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors
keywords: Epidemiology; Risk Factor