Seroprevalence of Helicobacter pylori infection in chronic chagasic patients, and in the rural and urban population from Uberlândia, Minas Gerais, Brazil

Abstract

As patients with chronic Chagas disease exhibit morphological and functional changes of the stomach (hypomotility and hypochlorhydria), malnutrition, immunological deficiency and high prevalence of peptic disease associated to Helicobacter pylori infection, the purpose of this study was to evaluate if the prevalence of H. pylori infection in chronic chagasic is higher than in non-chagasic individuals in the urban and rural population from Uberlândia, MG, Brazil. Serological determination of IgG antibodies to H. pylori was performed using a second-generation ELISA. Thus, 598 people were evaluated: 128 chagasic (CG), 222 non-chagasic living in urban area (U-NCG) and 248 non-chagasic living in rural area (R-NCG). Regarding the age range from 21 to 50 years, the prevalence of H. pylori infection in the CG (85.1%) was significantly higher than in the U-NCG (56.3%, p < 0.01) and the R-NCG (67.4%, p < 0.05). In the patients over 50 years, the prevalence in the CG (86.4%) was similar to the U-NCG (78.8%) and R-NCG (86.1%). Similar results were also found between the U-NCG and R-NCG for all age ranges, with prevalence rates of 29.1% and 35.3% for the age range from 5 to 13 years, and 47.2% and 40% for that from 14 to 20 years, respectively. We conclude that chagasic patients showed a higher seroprevalence of H. pylori infection than non-chagasic individuals, in the age range from 21 to 50 years, and that the prevalence of this infection was similar in the studied urban and rural non-chagasic population.

Histological and endoscopic features of the stomachs of patients with Chagas disease in the era of Helicobacter pylori

“…Moreover, in Brazil, which is considered a developing country, the overall prevalence of H. pylori is high and varies from 55% to 87% according to the geographical region 30,31 . Notably, no signifi cant differences in the prevalence of infection with H. pylori among the clinical forms of Chagas disease were observed in the present study or in other previous studies 16,17 .…”

“…Later, Pinazo et al 15 detected a high prevalence of H. pylori infection, which was diagnosed using the urea breath test, among Latin American immigrants living in Barcelona that had the digestive form of Chagas disease. Recently, two controlled studies 16,17 demonstrated a signifi cantly higher seroprevalence of H. pylori infection among chagasic patients independent of the clinical form of the disease; however, the gastric mucosa of the patients was not evaluated in either study or in the study by Pinazo et al 15 . Therefore, the aim of this study was to compare the prevalence of H. pylori infection and the gastric histological and endoscopic features of chagasic and non-chagasic patients and of chagasic patients with the digestive form of Chagas disease and those with other clinical forms because data regarding alterations in the gastric mucosa of chagasic patients, especially after the discovery of H. pylori, are lacking.…”

Characterization of Digestive Involvement in Patients with Chronic T. cruzi Infection in Barcelona, Spain

“…Some authors have hypothesized on a potential relationship between T. cruzi and H. pylori infections [14], probably in relation to common environmental risk factors. However, it has been suggested that hypochlorhydria and/or other gastric dysfunctions caused by T. cruzi infection could facilitate H. pylori transmission [14].…”

“…Even if in recent studies [13] dysphagia appeared as a specific and constant symptom in patients with megaesophagus, in general the symptoms of chronic digestive CD are non-specific, and there are numerous confounders, including other common infections [14], [15], megacolon at high altitude, and gastrointestinal problems related to the long-term consumption of coca leaves [16]–[18] or to migration-related changes in diet [19], [20] and stress. A diagnosis of CD may easily be missed if symptoms are not evaluated by a physician who knew of the epidemiology and the symptoms of the disease.…”

Diagnosis, management and treatment of chronic Chagas’ gastrointestinal disease in areas where Trypanosoma cruzi infection is not endemic

“…Since the prevalence of H. pylori infection in this population is moderate to high, [49][50][51][52][53] we recommend the evaluation of such infection in all patients presenting dyspepsia, pyrosis, or signs of postprandial abdominal distension. It is advisable to confirm H. pylori eradication at least four weeks after the end of treatment.…”