Seroprevalence of Helicobacter pylori infection in chagasic and nonchagasic patients from the same geographical region of Brazil

Abstract

Introduction:In this study, we evaluated the seroprevalence of Helicobacter pylori infection among chagasic and non-chagasic subjects as well as among the subgroups of chagasic patients with the indeterminate, cardiac, digestive, and cardiodigestive clinical forms. Methods: The evaluated subjects were from the Triângulo Mineiro region, Minas Gerais, Brazil. Chagasic patients showed positive reactions to the conventional serological tests used and were classified according to the clinical form of their disease. Immunoglobulin G antibodies specific to H. pylori were measured using a commercial enzyme-linked immunosorbent assay kit. Results:The overall H. pylori prevalence was 77.1% (239/310) in chagasic and 69.1% (168/243) in non-chagasic patients. This difference was statistically significant even after adjustment for age and sex (odds ratio = 1.57; 95% confidence interval, 1.02-2.42; p = 0.04) in multivariate analysis. The prevalence of infection increased with age in the non-chagasic group (p = 0.007, χ 2 for trend), but not in the chagasic group (p = 0.15, χ 2 for trend). H. pylori infection was not associated with digestive or other clinical forms of Chagas disease (p = 0.27).Conclusions: Our findings demonstrate that chagasic patients have a higher prevalence of H. pylori compared to non-chagasic subjects; a similar prevalence was found among the diverse clinical forms of the disease. The factors contributing to the frequent co-infection with H. pylori and Trypanosoma cruzi as well as its effects on the clinical outcome deserve further study. Keywords: Helicobacter pylori. Chagas disease. Chronic Chagas disease clinical forms. Co-infection. RESUMO Introdução:No presente estudo, foi comparada a soroprevalência da infecção por Helicobacter pylori entre os indivíduos chagásicos e não-chagásicos, bem como entre subgrupos de chagásicos com as formas clínicas indeterminada, cardíaca, digestiva e cardiodigestiva. Métodos: Os indivíduos avaliados eram provenientes da região do Triângulo Mineiro, Minas Gerais, Brasil. Foram realizados testes sorológicos convencionais para diagnóstico da infecção pelo T. cruzi e os chagásicos foram classificados de acordo com a forma clínica. O diagnóstico de infecção por H. pylori foi estabelecido pela detecção de anticorpos IgG específicos utilizando-se um kit comercial de ELISA. Resultados: A prevalência da infecção por H. pylori foi 77,1% (239/310) no grupo de pacientes chagásicos e 69,1% (168/243) no grupo de não-chagásicos. Esta diferença foi estatisticamente significativa mesmo após ajuste para idade e sexo (OR = 1,57; 95% CI, 1,02-2,42; p = 0,04) na análise multivariada. A prevalência da infecção aumentou de acordo com a idade no grupo não-chagásicos (p = 0,007, χ 2 for trend) mas este aumento não foi observado no grupo dos chagásicos (p = 0,15, χ 2 for trend). Não houve associação da infecção por H. pylori com a forma digestiva ou com qualquer outra forma clínica da doença de Chagas (p = 0,27). Conclusões: Foi demonstrado que pacientes chagásicos apresentam maior pre...

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 .…”

“…The high prevalence of co-infection with T. cruzi and H. pylori in our study (approximately 70%) and in other studies is not surprising because the transmission of both of these pathogens is associated with poor socioeconomic conditions [13][14][15][16][17] . 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 .…”

“…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.…”

Helicobacter pyloriand autoimmune disease: Cause or bystander

“…This could make it almost impossible to link the disease with the microbe in H. pylori A "multiple hit" mechanism of molecular mimicry-induced autoimmunity Figure 1 A "multiple hit" molecular mimicry mechanism involving microbial mimics originated from Helicobacter pylori and other microbes linked with primary biliary cirrhosis. The major autoepitope of primary biliary cirrhosisspecific anti-mitochondrial antibodies (PDC-E2, pyruvate dehydrogenase complex) shares amino acid similarities with 4 microbial mimics from Helicobacter pylori (H. pylori) [142] , N. aromaticivorans [154] , L. delbrueckii [155,156] , and E. coli [140,157,158] . The working hypothesis is that exposure of susceptible individuals to infections caused by these microbial agents will initiate humoral and cellular immune responses against microbial epitopes (in our case, these will be those sharing similarity with the selfepitope).…”

Minimally invasive esophagectomy in achalasia: a more liberal approach to esophageal resection

“…It is a chronic progressive motor disorder of esophageal peristalsis that results in dilatation, tortuosity, and elongation of the esophagus. Megaesophagus is commonly associated with pulmonary complications due to acute or chronic bronchoaspiration, and with a higher frequency of epidermoid esophageal cancer [2,3] secondary to stasis, chronic esophagitis, intraesophageal pH changes [4] , and the presence of bacteria [5] and viruses such as human papilloma virus (HPV) [6] , in addition to a high prevalence of Helicobacter pylori in the esophageal mucosa [7] .…”