Prevalence of Helicobacter pylori and cytotoxin-associated gene A in Iranian patients with non-erosive and erosive reflux disease

The prevalence of Helicobacter pylori (H. pylori) infection and its
virulent strain (cytotoxin-associated gene A: CagA) has not been evaluated in patients
with gastroesophageal reflux disease (GERD) subgroups (erosive and non-erosive) in
Iran. AIMS: This study was conducted to evaluate H. pylori infection and anti-CagA
status in GERD. SETTING AND DESIGN: One hundred fifty-four patients (71 male and
83 female; mean age, 42.6± 15.5 years) were evaluated for symptoms — heartburn
and acid regurgitation — compatible with GERD. MATERIALS AND METHODS: The
esophagus was diagnosed endoscopically whether it was with erosion (erosive reflux
disease, ERD) or without erosion (non-erosive reflux disease, NERD). Rates of anti–H.
pylori and anti–CagA-IgG (immunoglobulin G) antibodies were determined for each
subject by ELISA. H. pylori was considered by ELISA if the rapid urease test proved
positive. STATISTICAL ANALYSIS: anti H. pylori and anti-CagA statuses were compared
in ERD and NERD patients with and without related IgG antibodies. Mean values and P
values were calculated using SPSS (version 12). RESULTS: The overall prevalence of H.
pylori infection was 75.3% (116/154). Anti-CagA antibody was found in 60.3% (70/116)
of infected patients. The prevalence of H. pylori infection in patients with NERD and
ERD was 81.2% (56/69) and 70.6% (60/85), respectively (OR= 0.56; 95% CI [confidence
interval]= 0.26-1.20; P= .14). The prevalence of anti-CagA antibody in infected NERD
and ERD patients was 58.9% (33/56) and 61.7% (37/60), respectively (OR= 1.16; 95%
CI= 0.49-1.70; P= 0.83). CONCLUSION: The results showed that more than 70% of the
patients, either NERD or ERD, acquire H. pylori infection. Anti-CagA antibody is also
common in patients with reflux disorders in our community