Helicobacter pylori and non-alcoholic fatty liver disease: Is there a relationship?

Non-alcoholic fatty liver disease (NAFLD) is distinguished by liver injury due to metabolic stress, identified by diffuse hepatocyte macrovascular fatty lesions [1]. The prevalence of NAFLD is rising yearly, with a worldwide incidence rate between 20% and 30% [2]. Complex hereditary variables, improper lipid metabolism, and insulin resistance are the key characteristics of the etiology of NAFLD [3]. The research has revealed that aberrant lipid metabolism in the liver can result in dysbacteriosis in the intestinal flora; abnormality of the flora eventually encourages lipid deposition in the liver. Additionally, there is mounting proof that NALFD is linked to abnormalities in the gut flora, particularly Helicobacter pylori (H, pylori) [4]. Gram-negative bacillus, termed H pylori, has colonized the deep layers of the gastric mucosa. [5]. The global infection rate for H pylori is about 50% or higher [6]. According to research, H pylori causes gastric cancer, gastrointestinal lymphoma, peptic ulcers, and chronic gastritis [7]. Additionally, some researchers indicate a connection between H pylori and liver cancers, diabetes, and improper lipid metabolism [8]. Some studies have discovered that infection by H pylori is one of the elements for NAFLD to progress and that getting rid of H pylori can partially stop the evolution of NAFLD [9].

Helicobacter Pylori Treatment Eradication in Egypt: Standard Clarithromycin-based Triple versus Quadruple Regimen Therapy

Absence of adequate treatment for Helicobacter pylori (H. pylori) infection leads to prolonged life time colonization which is responsible for complications. Antibiotics resistance is the main cause of eradication failure in H. pylori infection, thus our study aimed to evaluate the efficiency and tolerability of standard triple therapy vs. quadruple regimen therapy in H. pylori eradication in Egypt.

The Assessment of Gastric Antral Wall Thickness in Helicobacter pylori Gastritis by Abdominal Ultrasonography, Case-Control Study (2016-2018)

Abdominal ultrasonography is effective in the visualization of gastric wall layers and measuring its thickness. The study aimed to assess gastric antral wall thickness in patients with H. pylori gastritis by abdominal ultrasonography and to study its predictive value in detecting H. pylori gastritis.

Sero-prevalence of and risk factors associated with Helicobacter pylori infections among individuals with peptic ulcer in Owerri, Imo State, Nigeria during 2020-2021

Background: Helicobacter pylori, which is a causative agent of chronic gastritis, duodenal ulcer and gastric cancer, presently affects approximately one half of the world population. This study was conducted to assess the epidemiology and risk factors for acquisition of H. pylori among individuals with and without peptic ulcer symptoms in Owerri, Nigeria, in order to provide baseline data and create awareness for effective management and prevention of infection caused by this pathogen. Methodology: A total of 384 participants, symptomatic and asymptomatic for peptic ulcer, were recruited from the three Local Government Areas (LGAs) of Owerri, Imo State, Nigeria. The symptomatic participants were randomly recruited among patients attending outpatient clinics with symptoms of peptic ulcer disease at the Federal Medical Center Owerri, general hospitals and primary healthcare centers across Owerri LGAs, while asymptomatic patients were recruited from the community. Information on socio-demographic characteristics of each participant and potential risk factors were collected with a pre-tested structured questionnaire. Blood samples were collected for detection of antibodies (IgG) using a one-step H. pylori test device while faecal samples were collected for detection of occult blood (from peptic ulceration) using faecal occult blood (FOB) test. Data were analyzed using SPSS version 25.0 and association of risk factors with H. pylori sero-prevalence was determined by the Chi-square or Fisher Exact test (with Odds ratio). P value < 0.05 was considered statistically significant.Results: The sero-prevalence of H. pylori infection among the study participants was 72.4% (285/384) while the prevalence of ulcer by FOB test was 71.1% (273/384). A total of 78.4% (214/273) of those with ulcers were seropositive for H. pylori while 64.0% (71/111) of those without ulcers were sero-positive for H. pylori (p=0.0045).Factors significantly associated with high sero-prevalence of H. pyloriwere age groups 41-50 (100%), 21-30 (78.4%) and 31-40 (67.6%) years (X 2=66.964, p<0.0001), illiteracy (OR=6.888, p<0.0001), unemployment (OR=2.427, p<0.0001), low social class status (X2=28.423, p=0.0003), drinking of unclean water (OR=5.702, p<0.0001), living in crowded rooms (OR=2.720, p<0.0001), eating food bought from food vendors (OR=3.563, p<0.0001), family history of ulcer (OR=12.623, p<0.0001), habits of eating raw vegetables and unwashed fruits (OR=6.272, p<0.0001), non-regular hand washing practices before meal (OR=2.666, p<0.0001) and presence of ulcer (OR=2.043, p=0.0045). However, smoking (OR=0.7581, p=0.2449) and gender (OR=0.6538, p=0.0796) were not significantly associated with sero-prevalence of H. pylori. Conclusion: There is need for comprehensive strategy including public health education campaign to create awareness on H. pylori, improve personal hygiene and environmental sanitation, provision of safe drinking water by the government to the populace, and discourage indiscriminate and open defecation

Management of Helicobacter pylori among medical doctors working in Khartoum, Sudan 2019: a cross-sectional study

Background: Various international guidelines have been developed regarding Helicobacter pylori (H. pylori) management, as it is infecting more than half of the world's population. Sudan's health system lacks guidelines regarding H. pylori management, leading to a discrepancy in practice. Investigating the current approach could be a step forward in the formulation of a national consensus in the management of H. pylori. Methods: A cross-sectional study was conducted among medical doctors currently working in Khartoum, Sudan. Participants were enrolled from platforms of medical associations through an online questionnaire. The questionnaire was scored out of 25 points, and scoring 13 or above considered a good approach. Data analysis was carried out using Statistical Package for Social Sciences (SPSS). Results: A total of 358 medical doctors participated in the study. The mean (±SD) score was 12.9(±4.5). Those who were using textbooks, campaigns, symposiums or general medical information to their primary Source of knowledge significantly scored higher. The most selected indication for both diagnosis (76.8%) and treatment (67.6%) was an active peptic ulcer. Stool antigen test (SAT) was the most preferred test (70.7%). The majority of respondents selected triple therapy (82.1%) as a first-line regimen. Only 37.7% confirmed the eradication after four weeks of stopping the treatment. They ensure eradication mainly through SAT (29%). Conclusion: A suboptimal approach was noted among medical doctors of Khartoum, Sudan, regarding H. pylori management. Efforts should be invested in forming national guidelines and the implementation of continuous medical education programs.

Anti-Helicobacter pylori activity of Egyptian medicinal plants and bacteriophages

Background: Helicobacter pylori (H. pylori) is the most common cause of gastric infections worldwide. Due to antibiotic resistance and adverse effects, phytotherapy and phage therapy have been a research focus as an alternative therapy for H. pylori infection. Objectives: To assess the medicinal plant extracts and bacteriophages as a treatment of H. pylori infection. Methodology: Thirty five gastric biopsies were cultured for H. pylori isolation. Screening of medicinal plants extract efficiency was done by Disc diffusion method. Minimum inhibitory concentrations of extracts were assessed. In vivo effect of Punica granatum peel extract was tested by bacterial density and histopathology in rats. Sewage water samples were screened for H. pylori specific bacteriophages. Single plaque isolation technique was used for phage purification. Results: Ten out of 35 (28.57%) patients had positive gastric biopsy for H. pylori by culture. Four out of 10 (40%) isolates were resistant to all antibiotics. Inhibitory effect of Rosemarinus officinalis, Syzygium aromaticum, Rhus coriaria and Ammi visagna on H. pylori was detected. Punica granatum extract was the most efficient in vitro. In vivo, Punica granatum peel extract caused significant reduction of bacterial density (Pty (P<0.05) and enhanced ulcer healing. Sewage water filtrates contained 3 types ofH. pylorispecific bacteriophages. During phagepurification,phage infectivity waslost.Conclusions:Punicagranatumpeel extract revealed better in vivo activity againstH. pylorithanv standard regimen antimicrobials. Other effective plants can be beneficial inH. Pylori infection management .Loss of bacteriophage infectivity may be an obstacle to phage therapy of H. pylori

Correlation between autoimmune thyroid diseases and helicobacter pylori infection

Background: Helicobacter Pylori (H. Pylori) usually acquired in childhood, it colonizes the gastric mucosa of about 50% of the world's population at some time in their life. In eastern countries, H. pylori infection has a prevalence of approximately 70%. Objective: To correlate between H. pylori infection and autoimmune thyroid diseases (AITD). Patients and Methods: This is a cross-sectional study done on 200 patients selected as a convenient sample with upper GI upset. They were selected from gastroenterology outpatient clinics at Al-Hussein and Alexandria Police Hospitals, during the summer months of 2018. They were classified according to the results of stool H. pylori Ag testing into two groups; positive and negative (each group 100 patient). This is cross-sectional study done on 200 patients selected as a convenient sample Results: Our results indicated that patients with H. pylori infection were more susceptible to AITD. There was significant association between H. pylori infection and both Hashimoto's and Graves' disease. H. pylori infection had shown to be associated with elevated liver enzymes, anemia, and IL 17. Conclusion: There is a significant positive relationship between H. pylori infection and Hashimoto's disease (HT). There is a significant positive relationship between H. pylori infection and Graves' disease (GD)

Helicobacter pylori seropositivity In hyperemesis gravidarum during pregnancy

Background: Prevalence of hyperemesis gravidarum varies from 0.3 to 1.5% of all live births. The exact cause is not well known and is probably multifactorial. It is the most common cause of hospitalization in the first half of pregnancy and second only to preterm labor for pregnancy overall. The etiology of emesis gravidarum remains unknown. But a number of possible causes have been studied as endocrinal, immunological, psychological, metabolic, genetic and even infectious such as helicobacter pylori infection. Aim of the Work: To assess the value of screening for helicobacter pylori seropositivity in hyperemesis gravidarum for better evaluating and improving the cure rate especially in resistant cases. Patients and methods: A prospective controlled comparative study was conducted on 100 pregnant women in the first trimester, where 50 of them were suffering from hyperemesis gravidarum (group A) and another 50 healthy women were chosen as a control group (group B). They were recruited from the outpatient clinic of Al-Galaa Maternity Teaching Hospital, Cairo, Egypt from January 2019 till August 2019. After approval of the local ethics committee, a written consent was obtained from each woman before inclusion in the study. Fasting and post prandial sugar, Liver and kidney function tests, thyroid function tests, CBC, urine and electrolyte examination as well as serum examination for IgG of helicobacter pylori were done for each one. Results: Serum helicobacter pylori IgG antibodies seropositivity and acetonuria was significantly higher in group A than in group B while serum sodium and potassium levels were significantly lower in patients with hyperemesis gravidarum than control group. Conclusion: The treatment of H. Pylori infection may reduce the risk of hyperemesis gravidarum and its complications

Benign effects of Helicobacter pylori in gastric mucosa among symptomatic Sudanese patients

Infection with Helicobacter pylori is a worldwide problem. It plays an important role in gastric malignancies.The pathogenesis of gastric malignancies involves multistep progression changes in gastric mucosa and the Helicobacter pylori infections is the first step in most of cases.Aim:The aims of this study were to clarify the benign changes in gastric mucosa after Helicobacter pylori infection;to evaluate the endoscopic and histological patterns of infection and to correlate endoscopic findingwith histopathological parameters.Materials and Methods:A descriptive, retrospective study was done in Soba University Hospital between January 2009 - February2013. Paraffin-embedded blocks, Giemsa and Haematoxylin and Eosin-stained slides, were obtained from 50 cases of Helicobacter pylori-associated chronic gastritis and examined under light microscopy. The clinical information and endoscopy findings were obtained from the records. The data was analyzed using Statistical Package for Social Sciences Software.Results:The most common affected age group was between 40-60 years. The prevalence of infection was equal in males and females. The commonest endoscopic finding was inflammation of gastric mucosa. Most patients presented with moderate degree of colonization; 62% of patients presented with a severe degree of chronic inflammation. There was a significant statistical correlation between the degree of Helicobacter pylori colonization and the degree of chronic inflammation (p<0.05). Most patients presented with severe degree of active gastritis. A significant correlation was found between the degree of chronic inflammation and degree of activity. The prevalence of lymphoid follicles in a single biopsy specimen from antral mucosa was 36%.The dysplasia was seen in 12%; eosinophilia 8%; atrophy 8% and intestinal metaplasia in 6% of the cases.No significant correlation was found between the endoscopic findings and histological findings.Conclusion:Helicobacter pylori infection causes chronic active gastritis and it has a role in the development of lymphoid follicles, intestinal metaplasia, atrophy and dysplasia

Etude de la prise en charge de l'infection à Helicobacter Pylori dans les villes de Pointe-Noire et de Brazzaville en 2015

Introduction : L'infection à Helicobacter Pylori affecte environ 50% de la population mondiale. Sa prévalence est plus élevée dans les pays en développement. Elle est à l'origine de pathologies gastroduodénales et son éradication est de ce fait recommandée.Nous avons réalisé une étude dont l'objectif a été d'évaluer les possibilités diagnostiques, thérapeutiques et la séroprévalence de l'infection à Helicobacter pylori dans les villes de Pointe-Noire et Brazzaville.Méthodes: Etude transversale descriptive et analytique menée de mars à septembre 2015.Résultats : Sur (7) sept tests existants et validés dans le monde; seuls (4) quatre tests étaient disponibles. La non disponibilité du test respiratoire à l'urée marquée au carbone 13 était à l'origine du non contrôle de l'éradication après traitement. Les protocoles d'éradication étaient la quadrithérapie séquentielle ou continue sur 10 jours sans sel de bismuth, non disponible au Congo-Brazzaville.Au total 130 patients ont été inclus; 54(41,5%) hommes et 76 (58,5%) femmes dont 121 (93,1%) patients étaient testés positifs à l'helicobacter pylori, avec une prédominance féminine. Le reflux gastro-oesophagien était la pathologie la plus représentée chez les patients testés positifs mais sans différence significative (P=0,287).Conclusion: L'insuffisance des tests diagnostiques de l'infection à Helicobacter pylori notamment du test respiratoire à l'urée marquée au carbone 13 au Congo-Brazzaville ne permettait pas aux praticiens de contrôler l'éradication. La quadrithérapie bismuthée n'était non plus disponible alors que la séroprévalence hospitalière reste élevée. Ainsi nous faisons le plaidoyer pour l'acquisition du test respiratoire à l'urée marquée au carbone 13 et la mise sur le marché des sels de Bismuth au Congo-Brazzaville

Prevalence of helicobacter pylori infection among suspected peptic ulcer patients in Port Harcourt, Southsouth, Nigeria

Background information Helicobacter pylori is a ubiquitous organism that causes infections that are asymptomatic, and with no specific clinical signs and symptoms. Various diagnostic tests for H. pylori have been developed. This study was intended to understand the prevalence of H. pylori among suspected peptic ulcer patients in a tertiary medical facility in Port Harcourt. Methodology The ninety-eight (98) patients who consented were properly instructed before being given a capsule containing urea. This was swallowed with 50mls of water and they waited for ten minutes, after which, they breathed into a breath card until the indicator changed colour from orange to yellow. The breath card was then inserted into a device which detects the production or otherwise of the carbon dioxide with isotopically labelled carbon by displaying positive if present or negative if absent.Result In this study, out of the forty-five male and fifty-three female subjects that participated in this study, a study prevalence of 39.8% was observed. Also, a male to female prevalence ratio of 15.3:24.5 was observed with no statistical significance (X2=0.1519, P=0.6911). Similarly, the age group distribution of H. pylori infection among the male population showed age group 41-50 years as the modal (11.6%) prevalence, followed by age group 51-60 years (9.3%) with P>0.05 (X2=3.478, P=0.7470). In the same vein, the female distribution of H. pylori infection revealed that there was no significance among the different study groups with P>0.05 (X2=3.115, P=0.7943) and age group 31-40 years (16.1%) had the modal prevalence. Conclusion The high incidence of H. pylori infection among suspected peptic ulcer patients in Port Harcourt has been established, though not as high as other studies elsewhere. Therefore, public enlightenment should be encouraged by all public health stakeholders to arrest this trend

Peptic ulcer Disease drugs usage patterns and its economic burden in a tertiary health institution in Niger Delta, Nigeria

Background: Drug utilization evaluation for peptic ulcer disease and its cost implication are rare in Niger Delta. The objective of the study was to evaluate drug usage pattern in peptic ulcer diseases as well as its cost implications.Methods: The cross sectional drug use evaluation study involving the use of questionnaire and patient case notes was carried out in a tertiary health institution. The validated pretested questionnaire was interviewer administered to 300 patients sampled consecutively followed by a retrospective review of their respective case notes between April to November 2013. Information collected include risk factors, prescribed drugs, Helicobacter pylori assay test results among others. Cost of each drug and therapy were then computed appropriately. Data was analyzed using Statistical package for Social Sciences (SPSS) version 20, Microsoft Excel and Graph Pad Prism for windows Instat Version 3.Results: Out of the 300 patients, H. pylori test was conducted in 262 (87.3%) while the presence or absence of the organisms could not be confirmed in the remaining 38 subjects. Out of the 262 patients with H. pylori test results, only 166 representing 63.4% were positive. History of non-steroidal anti-inflammatory drugs (NSAID) usage was very high among the subjects (250; 83.3%) and highest for ibuprofen 146 (48.7%). The most prescribed drugs were antacids (268; 89.3%), amoxicillin (165; 55.0%), and a combined formulation of omeprazole, tinidazole, and clarithromycin in 140 (46.7%) subjects, followed by omeprazole alone (125; 41.7%).The national direct cost implication for the estimated 17.6 million is in the range of NGN186,849,000,000.00 ($958,200,000.00), out which NGN109,867,000,000.00($563,420,513.00) was for PUD drugs (50.9%) and NGN32,698,575,000.00 ($167,685,000.00) for H. pylori tests (17.5%), while the remaining 31.7% valued at NGN59,231,133,000.00 ($303,749,400.00) was for non-ulcer drugs, personnel and transportation.Conclusion: The pattern of drugs usage is consistent with standard treatment guidelines. Peptic ulcer drugs for the 300 subjects constituted NGN1,618,641 ($8300.72) which represents 73.0% of the total amount spent on drugs. The national direct cost of PUD is close to NGN200 billion ($1.04 billion). Updated information on drug usage and their costs is needed for improved usage and system efficiency

Impact of Helicobacter pylori Eradication on Absolute Telomere Length in Gastric Mucosa

Background and study aim: This study proposed to assess the relation between absolute telomere lengths (TLs) in gastric mucosa and Helicobacter pylori (H. pylori) infection and study the impact of (H. pylori) eradication therapy on TLs. Patients and Methods: This study was conducted on (42) subjects divided into two groups, group I: included (17) H. pylori negative cases served as control group, group II: included (25) H. pylori positive patients. Absolute TLs was measured in base pairs (bp) in gastric mucosa and analyzed by real time polymerase chain reaction (RT-PCR) in all groups and reevaluated in H. pylori positive patients 4 weeks after eradication therapy. Results: Prior to eradication therapy, there was highly significant shortening (P<0.001) in TLs (bp) in gastric mucosa of H. pylori positive patients compared to H. pylori negative controls. While there was highly significant elongation was observed after H. pylori eradication therapy in H. pylori positive patients (P < 0.001). There was significant negative correlation between TLs and ages of patients (P<0.001) while there was no significant relation between TLs and sex (P= 0.5) before and after eradication therapy. Conclusion: H. pylori positive patients had significantly shorter TLs than H. pylori negative controls. TLs were increased after H. pylori eradication therapy in H. pylori positive cases. This finding may indicate the importance of H. pylori eradication to avoid the development of gastric cancer by its effect on TLs

Analyse démographique et endoscopique des patients atteints d'ulcère gastroduodénal à Yaoundé au Cameroun : qu'est ce qui a changé depuis les années 1990 ?

Objectif : La prévalence de l'ulcère gastro-duodénal semble être en diminution marquée ces dernières années dans les pays africains. Au Cameroun en 1990, elle était de 32%. L'objectif de notre étude était d'évaluer l'évolution de la prévalence de l'ulcère gastroduodénal et d'identifier ses caractéristiques démographiques et endoscopiques à Yaoundé, 25 ans après.Patients et méthodes : Etude rétrospective de la période allant du 1er janvier 2011 au 31 décembre 2014 dans trois hôpitaux universitaires de Yaoundé. Les comptes rendus d'endoscopie de 4685 patients consécutifs référés pour une endoscopie digestive haute ont été réexaminés. Nous avons inclus 489 patients (312 hommes et 177 femmes) avec un ulcère gastro-duodénal prouvé en endoscopie. Les données démographiques et endoscopiques ont été recueillies. Résultats : L'ulcère duodénal et l'ulcère gastrique étaient identifiés respectivement chez 295 (60,3%) et 157 (32,1%) patients, la double localisation gastrique et duodénale chez 37(7,6%), faisant une prévalence globale de 10,4%. L'âge moyen des patients était de 48,9 ans (extrêmes : 4 à 90 ans). Les patients ulcéreux gastriques étaient relativement plus âgés que les patients ulcéreux duodénaux (54,4 ans vs. 45,4 ans, p < 10-5). Le ratio homme/femme était de 2,2/1 pour l'ulcère duodénal et 1,2/1 pour l'ulcère gastrique. La prévalence globale de l'infection à H. pylori à l'histologie et/ou au test rapide à l'uréase était de 63,0% (308/489). L'infection était plus fréquente dans l'ulcère duodénal que gastrique (67,8% vs. 51,0%, p = 0,0005). L'ulcère gastro-duodénal était révélé par les épigastralgies (71,8%) et l'hémorragie (31,5%). L'hémorragie était liée à l'ulcère duodénal (p = 0,07) et au sexe masculin (p = 0,01). Il n'y avait pas de différence significative selon l'âge (p = 0,16). H. pylori protégeait contre l'hémorragie, risque relatif 0,7 (IC à 95% : 0,6-0,8 ; p = 0,00006).Conclusion : La prévalence de l'ulcère gastroduodénal a significativement diminué au Cameroun par rapport à 1990. Les patients ulcéreux sont devenus plus âgés avec une tendance à l'occidentalisation de la maladie ulcéreuse

Intra- and interobserver reproducibility of grading of helicobacter pylori gastritis according to the updated sydney system

Aims. To study the intra- and interobserver reproducibility of Sydney System amongst pathologists in Cameroon as Sydney System gradation has not gained enough confidence in African pathologists. Methods. We performed a descriptive study including 100 patients who benefited from gastric biopsy by endoscopy. These biopsy specimens were stained with hematein and eosin and modified Giemsa; and read independently using the same microscope by two pathologists with four years experience and no experience with the updated Sydney System. Gastritis was graded according to the updated Sydney System. Levels of intra- and interobserver reproducibility were assessed using the unweighted kappa coefficient. Results. The intraobserver reproducibility of gradation of Helicobacter pylori density; activity; chronic inflammation; atrophy; and intestinal metaplasia showed respective values of kappa: 0.63; 0.34; 0.61; 0.48; and 0.82 for one observer against 0.42; 0.005; 0.41; 0.31; and 0.72 for the other. Interobserver reproducibility kappa values were; respectively; 0.41; 0.18; 0.57; 0.58; and 0.82. Conclusion. Results are encouraging but experience in the updated Sydney System should be improved. The later should be introduced as a means to grade and classify gastritis in Cameroon and African countries

Study of the correlation between Helicobacter pylori infection and Hepatic Encephalopathy in patients with Liver Cirrhosis

Background and study aim: Ammonia plays a major role in hepatic encephalopathy pathogenesis. Most of ammonia is known to be produced by the action of colonic bacteria which possess a urease enzyme activity. H. pylori which infects the stomach possesses a stronger urease activity which produce a large amount of ammonia that may precipitate hepatic encephalopathy (HE). The aim of the present study is to determine the correlation between Helicobacter pylori infection and HE in patients with liver cirrhosis.Patients and Methods: One hundred patients (50 patients of liver cirrhosis with hepatic encephalopathy and 50 patients of liver cirrhosis without hepatic encephalo-pathy) were evaluated for presence of H. pylori by stool antigen test (ELISA method) and for blood ammonia level estimation.Results: Prevalence of H. pylori infection in the study groups (patients of liver cirrhosis with and without hepatic encephalopathy) was 70% (liver cirrhosis with hepatic encephalopathy group (A) 80%, and liver cirrhosis without hepatic encephalopathy group (B) 60%). Mean blood ammonia levels were: 82.14± 47.9 mmol/l for group A (liver cirrhosis with hepatic encephalopathy) and 36.44± 17.9 mmol/l for group B (liver cirrhosis without hepatic encephalopathy). Prevalence of H. pylori and blood ammonia level were found significantly increasing with the severity and the degree of hepatic encephalopathy.Conclusion: There is a significant association between H. pylori and hepatic encephalopathy in patients with liver cirrhosis. There may be a role of anti-H. pylori therapy in patients of hepatic encephalopathy and should be investigated further

Cancer gastrique et infection à Helicobacter pylori en RD Congo. Aspects épidémiologiques

Objectif: Décrire le profil épidémiologique des lésions pré-cancéreuses et cancéreuses gastriques et la fréquence de leur association à l'infection à Helicobacter pylori.Matériel et méthodes: Enquête documentaire couvrant la période de 2001 à 2011,issue des registres reprenant les protocoles anatomopathologiques des analyses des biopsies gastriques effectuées dans les laboratoires d'anatomie pathologique des Cliniques Universitaires de Kinshasa, du centre Lomo Médical, de l'Institut National de Recherche Biologique (INRB), et de l'Hôpital Général de référence de Bukavu. La fréquence de lésions et l'association à l'infection à H. pyloriont été déterminées. Résultats: Cent dossiersdes patients avec lésions pré-cancéreuses ou cancéreuses gastriques ont été analysés. Leur âge moyen était de 54,8 ±13,3 ans. La fréquence du cancer a paru plus élevé dans les provinces de l'Est du pays (p = 0,005); avec l'adénocarcinome gastrique comme la forme la plus fréquente (83%). L'infection à Helicobacter pylori n'a été observée que chez 20% des patients. Conclusion: Le cancer gastrique, surtout l'adéno-carcinome est un cancer fréquent, prédominant surtout dans les régions orientales de la R D Congo. Ce cancer touche des sujets relativement jeunes. Des mesures préventives ciblées s'imposent

Genetic Determinants and Clinico-Pathological Outcomes of Helicobacter Pylori Infection

Helicobacter pylori is a spiral Gram-negative bacterium with a relatively small genome and is known to be the most common human bacterial infection worldwide; infecting about half of the world's population. The bacterium represents one of the most successful human pathogens; inducing severe clinical symptoms only in a small subset of individuals; thus signifying a highly balanced degree of co-evolution of H. pylori and humans. The prevalence of Helicobacter pylori infection varies greatly among countries and among population groups within the same country; but is falling in most developed countries. The clinical course of H. pylori infection is highly variable and is influenced by both microbial and host factors including genetic susceptibility while the pattern and distribution of inflammation correlate strongly with the risk of clinical sequelae; namely duodenal or gastric ulcers; mucosal atrophy; gastric carcinoma; or gastric lymphoma. Cytokine gene polymorphisms directly influence inter-individual variation in the magnitude of cytokine response; and this clearly contributes to an individual's ultimate clinical outcome. Polymorphisms in genes coding for innate immune factors have also been incriminated in the pathogenesis of H. pylori related disease; while promoter hypermethylation of tumor suppressor genes is considered an important factor in carcinogenesis and known to be present in H. pylori associated gastric tumors. Functional genomics may fill many of the gaps in our understanding of the pathogenesis of H. pylori infection and accelerate the development of novel therapies; including H. pylori specific antimicrobial agents

Helicobacter pylori cagA Gene in Egyptian sewage workers

A comparative cross-sectional study was conducted on 60 sewage workers and 30 matched unexposed referents from Mansoura city; Egypt; to estimate the prevalence and risk factors of Helicobacter pylori (H. pylori). Stool culture and detection of H. pylori antigen were done. In addition; the polymerase chain reaction (PCR) amplification of cytotoxin-associated gene A (cagA) gene in H. pylori in stool samples was carried out. The prevalence of H. pylori in sewage workers was 56.7% compared to 16.7% in the comparison group with a highly statistically significant difference between both groups. H. pylori cagA gene was present in 64.7% of H. pylori-infected sewage workers compared with 40% of controls. cagA gene was associated with more dyspeptic symptoms (77.3%) in infected workers compared to those of noninfected ones (33.3%) (P = .041). The risk of H. pylori was significantly higher among workers with poor compliance with personal protective equipment (PPE) (OR = 3.00); with duration of work 20 years (OR = 4.71); older than 45 years (OR = 4.27); and of low education level (OR = 11.2). We concluded that H. pylori infection and heartburn with or without epigastric pain are significant health problems in the studied sewage workers. Low education and poor compliance with PPE were the only predictors of H. pylori infection in sewage workers

Prevalence of Helicobacter Pylori Caga and Vaca Allelic Variants and Associated Disease Outcomes in Kenyan Patients with Dyspepsia

Although Helicobacter pylori has been linked to various gastric disorders in Western countries and Asia; its aetiopathological role in African populations is controversial. The aim of this study was to investigate the role of H. pylori and its virulence genotypes in gastrointestinal diseases in Kenyan patients with dyspepsia. Gastric biopsy specimens were obtained for DNA isolation and histopathological analysis. Amplification was performed using specific oligonucleotide primers. H. pylori positivity was determined by H. pylori stool antigen test; rapid urease test; and histology and molecular diagnostic tools. H. pylori was detected with high frequency in patients with gastritis; peptic ulcer disease (PUD) and gastro-oesophageal reflux disease. This implies a significant risk of the development of these pathologies (p-value = 0.0000 in all cases). H. pylori strains with cagA occurred more frequently in PUD (65.2). vacA s1a genotype appeared to play a more significant pathological role (82.6 PUD) than the other variants (p-value = 0.0142). The prevalence of vacA m1 was significantly higher in gastritis cases (p-value = 0.0253). vacA m2 was found to be significantly associated with gastritis (p-value = 0.0253). This finding may point to the fact that H. pylori vacA m1 and vacA m2 are independently associated with an increased risk for gastritis. Indications are that H. pylori prevalence in Kenya may be declining. The independently occurring H. pylori genotypes; as opposed to simultaneous carriage; could be the reason for the low distribution of H. pylori pathologies