Prevalence of Helicobacter pylori vacA, cagA, and iceA Genotypes in Cuban Patients with Upper Gastrointestinal Diseases.

Virulence factors of Helicobacter pylori can predict the development of different gastroduodenal diseases. There are scarce reports in Cuba about H. pylori isolates genotyping. The aim of the present investigation was to identify allelic variation of the virulence genes vacA, cagA, and iceA in sixty-eight patients diagnosed as H. pylori positive by culture. In seven out of 68 patients, strains from both gastric regions were obtained and considered independent. DNA was extracted from all the H. pylori strains and evaluated by PCR-genotyping. The vacA s1 allele, cagA gene, and iceA2 allele were the most prevalent (72.0%, 56.0%, and 57.3%, respectively). Alleles from m-region showed a similar frequency as s1a and s1b subtypes. The presence of multiple H. pylori genotypes in a single biopsy and two gastric region specimens were found. Significant statistical association was observed between iceA2 allele and patients with non-peptic ulcer dyspepsia (NUD) (P = 0.037) as well as virulence genotypes (s1, s1m2) and patients over 40 years old (P < 0.05). In conclusion, the results demonstrated a high prevalence of H. pylori virulent genotypes in Cuban patients over 40 years old while iceA2 alleles demonstrated a good specificity in patients with NUD.

Genetic Diversity of the Hepatitis B Virus Strains in Cuba: Absence of West-African Genotypes despite the Transatlantic Slave Trade.

Cuba is an HBsAg low-prevalence country with a high coverage of anti-hepatitis B vaccine. Its population is essentially the result of the population mix of Spanish descendants and former African slaves. Information about genetic characteristics of hepatitis B virus (HBV) strains circulating in the country is scarce. The HBV genotypes/subgenotypes, serotypes, mixed infections, and S gene mutations of 172 Cuban HBsAg and HBV-DNA positive patients were determined by direct sequencing and phylogenetic analysis. Phylogenetic analysis of HBV S gene sequences showed a predominance of genotype A (92.4%), subgenotype A2 (84.9%) and A1 (7.6%). Genotype D (7.0%) and subgenotype C1 (0.6%) were also detected but typical (sub)genotypes of contemporary West-Africa (E, A3) were conspicuously absent. All genotype A, D, and C strains exhibited sequence characteristics of the adw2, ayw2, and adrq serotypes, respectively. Thirty-three (19.1%) patients showed single, double, or multiple point mutations inside the Major Hydrophilic domain associated with vaccine escape; eighteen (10.5%) patients had mutations in the T-cell epitope (amino acids 28-51), and there were another 111 point mutations downstream of the S gene. One patient had an HBV A1/A2 mixed infection. This first genetic study of Cuban HBV viruses revealed only strains that were interspersed with strains from particularly Europe, America, and Asia. The absence of genotype E supports previous hypotheses about an only recent introduction of this genotype into the general population in Africa. The presence of well-known vaccine escape (3.5%) and viral resistance mutants (2.9%) warrants strain surveillance to guide vaccination and treatment strategies.

Phenotypic and genetic characterization of antimicrobial profiles of Helicobacter pylori strains in Cuba.

The study evaluated the antibiotic resistance patterns of Helicobacter pylori strains against metronidazole and clarithromycin in a hospital in Havana, Cuba. Eighty-five percent, 22.5%, and 10% of 40 H. pylori strains investigated were resistant to metronidazole, ciprofloxacin, and clarithromycin respectively but all were susceptible to amoxicillin and tetracycline. RdxA truncation was found only in metronidazole-resistant strains. In such strains, reported are eight and two novel mutations in the rdxA and frxA genes respectively. Two-point mutations in the 23S rRNA genes of clarithromycin-resistant strains were detected. A high prevalence of metronidazole resistance was found in Cuban H. pylori strains. Mutations in the rdxA gene may contribute more significantly than frxA gene to the high level of resistance to metronidazole. This study supports the need to continue monitoring the antibiotic susceptibility in H. pylori in Cuba to guide the treatment of such infection.

Acción de la celulosa microcristalina en la excreción de ácidos biliares totales en heces fecales / Effect of microcrystalinne cellulose in the excretion of total biliary acids in feces

The colorectal neoplasia is the second cause of death from neoplasia in our country, and in international statistics, blaming forthis, the dietetic habits of industrialized countries having a high content of satured fat, cholesterol, refined carbohydrate, red meat, and with few dietetic fibers. In the last years special attention has been focused to the action of the total biliar acids (TBA) primarily the secondary ones, over the colon mucosa, showing evidences of cancerous effects. Recently, American authors have published the favoring action of the cellulose fiber over the TBA through a catalytic reaction and their polysterification, inactivating them in their aggressive action over the colon mucosa. Through these experiences and willing to prove the action of the product, we have treated with mycrocristalline cellulosa (Microcel Lab. Blanver, Brasil) 20 patients of the Institute of Gastroenterology of Havana City, who showed high figures of TBA in stools for 2 months, compared with the 5 g. dose per day. Another group of 20 patients also with high figures of TBA in stools being treated with corn fecula same dose, same time by equal time. making every month determinations to both groups, determinig that in the first group the figures of TBA in stools were normalized in 95 per cent the first month of treatment and in 100 per cent the second month. The second group had only an answer of 65 per cent the first month and of 80 per cent the second month, which shows evidently the high efficacy of Microcel in reducing the TBA in stools.

Acción de la celulosa microcristalina en la excreción de ácidos biliares totales en heces fecales / Effect of microcrystalinne cellulose in the excretion of total biliary acids in feces

The colorectal neoplasia is the second cause of death from neoplasia in our country, and in international statistics, blaming forthis, the dietetic habits of industrialized countries having a high content of satured fat, cholesterol, refined carbohydrate, red meat, and with few dietetic fibers. In the last years special attention has been focused to the action of the total biliar acids (TBA) primarily the secondary ones, over the colon mucosa, showing evidences of cancerous effects. Recently, American authors have published the favoring action of the cellulose fiber over the TBA through a catalytic reaction and their polysterification, inactivating them in their aggressive action over the colon mucosa. Through these experiences and willing to prove the action of the product, we have treated with mycrocristalline cellulosa (Microcel Lab. Blanver, Brasil) 20 patients of the Institute of Gastroenterology of Havana City, who showed high figures of TBA in stools for 2 months, compared with the 5 g. dose per day. Another group of 20 patients also with high figures of TBA in stools being treated with corn fecula same dose, same time by equal time. making every month determinations to both groups, determinig that in the first group the figures of TBA in stools were normalized in 95 per cent the first month of treatment and in 100 per cent the second month. The second group had only an answer of 65 per cent the first month and of 80 per cent the second month, which shows evidently the high efficacy of Microcel in reducing the TBA in stools. (AU)