Prevalence, diversity and disease association of Helicobacter pylori in dyspeptic patients from Pakistan

Abstract

Introduction: The etiological association of Helicobacter pylori with gastric ulcer (GU), gastric cancer (GC), and duodenal ulcer (DU) is well-known. Understanding the epidemiology of H. pylori facilitates the estimation of disease burden in a certain population. This study presents the diversity of H. pylori genotypes and their association with different clinical outcomes among dyspeptic patients in Pakistan over a period of four years. Methodology: Gastric biopsy samples from a total of 450 dyspeptic individualswere subjected to PCR, genotypingand histology. Results: A total of 201 (45%) cases were found positive for H. pylori. The detection rate was high in GU (91%), DU (86%) and GC (83%) cases compared with those cases who had intact gastric mucosa (18%). Histology revealed the presence of infection in 68% of cases of mild/chronic nonspecific gastritis with others belonging to the GU sequel. cagA gene carriage was observed in 104 (51%) cases or mostly from DU, GU and GC groups, of which 97 were Western type strains while 3 were East-Asian type strains that are rarely observed in South Asia. vacA allelic variant s1am1 was most commonly observed, followed by s1am2, and s1bm1, with direct correlation in diseased cases (gastritis, GU, DU and GC). Prevalent genotypic combinations were s1am1/cagA -in gastritis and s1am1/cagA + in DU, GU, and GC. Conclusions: Our study indicates the predominant circulation of Western type cagA and vacAs1am1 type H. pylori strains in Pakistan.

Helicobacter pylori vacuolating cytotoxin genotypes and preneoplastic lesions or gastric cancer risk: a meta‐analysis

“…When a subgroup analysis was performed, the difference between groups was statistically significant (Q bet = 18.376, df = 2, P = 0) based on an ANOVA. The overall prevalence of vacA-s1m2 and vacA-s2m1 28,32,36,38 genotypes was 32.3% (122/378) and 6.6% (5/76) in GC patients and 29.0% (364/1255) and 9.9% (31/315) in controls, respectively, with no significant difference (Fig. 3: C2-C3; Table 2).…”

“…The prevalence of the vacA-m1 genotype in GC patients was investigated in 23 studies. 7,9,10,[13][14][15][16][17]23,[28][29][30][31][32][33]36,[38][39][40][41][42][43][44] The overall prevalence of the vacA-m1 genotype was 64.8% (402/620) in GC patients and 52.8% (948/1796) in controls. The pooled RR in a random-effects model was 1.431 (95% CI, 1.180-1.735, P = 0; Fig.…”

Prevalence of H. pylori in gastric biopsy specimen in the southeastern region of Turkey

“…In a study that included 450 patients with gastric symptoms, H. pylori was detected in biopsy specimens of 201 (45%) patients via PCR [39]. While 32% of patients had normal gastric mucosa, 68% had different gastroduodenal lesions.…”

Gastrointestinal, Liver and Biliary Tract Pathology: A Histopathological and Epidemiological Perspective from Pakistan with a Review of the Literature

“…cagA and vacA are predominant (Khan et al, 2013). Owing to the high prevalence of H pylori infection in Asia and its strong association with gastric carcinoma, Asia-Pacific consensus guidelines for management of H pylori infection have been developed (Fock et al, 2009).…”