Prevalence of Helicobacter pylori infection among blood donors in Saxony-Anhalt, Germany – a region at intermediate risk for gastric cancer

Abstract Background In the federal state of Saxony-Anhalt, gastric cancer (GC) incidence ranks among the highest in Germany. Helicobacter pylori prevalence is a surrogate marker for GC risk in a given population. In 2010 we reported an H. pylori seroprevalence of 44.4 % in patients at the emergency ward of the University Hospital of Magdeburg, the capital of Saxony-Anhalt. Our aim is to update these findings in a cohort of healthy blood donors from the same region. Materials and methods The sera of 516 consecutive blood donors (40.1 ± 14.1 years; 286 males and 230 females) were tested for antibodies against H. pylori and CagA. Data on demographics and previous H. pylori eradication therapy were obtained by means of a structured questionnaire. Blood donors with positive serology for H. pylori or CagA and/or history of eradication therapy were classified as H. pylori-positive. Results Overall, 28.9 % of the study cohort were H. pylori-positive. The prevalence was higher in older generations (9 % in 18 – 20 years up to 47 % in 61 – 70 years). In 44.4 % of H. pylori IgG-positive donors, CagA serology was also positive. This proportion was not age-dependent. Study participants with siblings were by trend more often H. pylori-positive (p = 0.066). Conclusion Compared to our previous study in patients at the emergency ward, we found by trend lower age-related H. pylori prevalence rates. In our cohort of healthy blood donors, we confirmed a lower H. pylori prevalence in younger generations.

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Prospective Assessment of Helicobacter Pylori Infection and Gastric Pathologies in Sidi Bel Abbes region, Western Algeria

South Asian Journal of Experimental Biology ◽

10.38150/sajeb.7(5).p217-224 ◽

2018 ◽

Vol 7 (5) ◽

pp. 217-224

Author(s):

Zouaouia Chama ◽

Khedoudj Kanoun ◽

Fatima Zohra Elkadi ◽

Kara Turqui Douidi ◽

Noria Harir ◽

...

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Histological Study ◽

Helicobacter Pylori Infection ◽

University Hospital ◽

Infection Prevalence ◽

Gastric Diseases ◽

Number Of Patients ◽

H Pylori ◽

The Impact

Helicobacter pylori infection concerns half of the world’s population, mainly in developing countries. It causes several gastrodudenal pathologies such as gastritis, ulcer and gastric adenocarcinoma. The aim of our study was to determine the prevalence of H.pylori infection and to assess the impact of different epidemiological factors as well as principal gastric diseases associ-ated to this infection. We underwent a prospective study during 18 months (month 2016-month 2017) which implicated 201 symptomatic patients for gastric fiboptic endoscopy at the level of Sidi Bel Abbes University hospital. We collected patients’ biopsies to perform a histological study and H. pylori culture. H. pylori identification was carried out based on bacteriological and biochemical analysis. The middle age of our population was (47.29 ±15.97ans) and the sex-ratio =0,8. The global prevalence of Helicobacter pylori infection is of 61.2% (123/201). This rate, after a statistic analysis, seems to be significantly related to age. It is particularly high especially for patients belonging to age range (20-30)-(51-60) years. The gender did not affect the infection prevalence that is more frequent in the gastritis case. We noticed also that HP infection prevalence was important in SBA the hospital. The range age (20-30)-(51-60) years had the highest prevalence of H. pylori and of gastritis which might be a risky ground of gastric cancer appearance. The ulcer pathology maximal rate concerned the group of 51 to 60 years. Above this age, this rate dropped whereas the number of patients suffering from gastric cancer, which presents an important rate in our study, increase for the group of 61-70 years.

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Evaluation of the Epidemiologic Efficacy of Eradicating Helicobacter pylori on Development of Gastric Cancer

Epidemiologic Reviews ◽

10.1093/epirev/mxz006 ◽

2019 ◽

Vol 41 (1) ◽

pp. 97-108 ◽

Cited By ~ 2

Author(s):

Fujiao Duan ◽

Chunhua Song ◽

Jintao Zhang ◽

Peng Wang ◽

Hua Ye ◽

...

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Population Attributable Risk ◽

Eradication Therapy ◽

Attributable Risk ◽

Chinese Patients ◽

Controlled Trials ◽

Mixed Effect ◽

H Pylori ◽

Development Of Gastric Cancer

Abstract Eradication of Helicobacter pylori colonization has been reported to affect the progression of gastric cancer. A comprehensive literature search was performed from 1997 to 2017 using electronic databases. All randomized controlled trials (RCTs) and nonrandomized controlled trials (non-RCT) evaluated the effect of H. pylori eradication on development of gastric cancer. Four RCTs and 9 non-RCTs were included (n = 40,740 participants; 321,269 person-years). Overall, H. pylori eradication therapy was associated with a significantly reduced risk of gastric cancer (incidence rate ratio (IRR) = 0.52, 95% confidence interval (CI): 0.41, 0.65). Results of mixed-effect Poisson regression meta-analysis were similar to those of traditional meta-analyses. In stratified analyses, the IRRs were 0.59 (95% CI: 0.41, 0.86) in RCTs and 0.48 (95% CI: 0.36, 0.64) in non-RCTs. The IRRs were 0.45 (95% CI: 0.34, 0.61) in patients and 0.63 (95% CI: 0.44, 0.90) in the general population. Moreover, the relative risk reduction was approximately 77% on the development of noncardiac gastric cancer with H. pylori eradication therapy in China. Attributable risk percentage and population attributable risk percentage for Chinese patients were 77.08% and 75.33%, respectively, and for Japanese patients were 57.80% and 45.99%, respectively. H. pylori eradication therapy reduces the risk of noncardiac gastric cancer development. The findings indicate the importance of early intervention with H. pylori eradication therapy from the perspective of epidemiology.

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Eradication of Helicobacter pylori and Gastric Cancer: A Controversial Relationship

Frontiers in Microbiology ◽

10.3389/fmicb.2021.630852 ◽

2021 ◽

Vol 12 ◽

Author(s):

Mariagrazia Piscione ◽

Mariangela Mazzone ◽

Maria Carmela Di Marcantonio ◽

Raffaella Muraro ◽

Gabriella Mincione

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Atrophic Gastritis ◽

Precancerous Lesions ◽

Eradication Therapy ◽

Developed Countries ◽

Gastric Carcinogenesis ◽

Gastric Disease ◽

Type I ◽

H Pylori

Worldwide, gastric cancer (GC) represents the fifth cancer for incidence, and the third as cause of death in developed countries. Indeed, it resulted in more than 780,000 deaths in 2018. Helicobacter pylori appears to be responsible for the majority of these cancers. On the basis of recent studies, and either alone or combined with additional etiological factors, H. pylori is considered a “type I carcinogen.” Over recent decades, new insights have been obtained into the strategies that have been adopted by H. pylori to survive the acidic conditions of the gastric environment, and to result in persistent infection, and dysregulation of host functions. The multistep processes involved in the development of GC are initiated by transition of the mucosa into chronic non-atrophic gastritis, which is primarily triggered by infection with H. pylori. This gastritis then progresses into atrophic gastritis and intestinal metaplasia, and then to dysplasia, and following Correa’s cascade, to adenocarcinoma. The use of antibiotics for eradication of H. pylori can reduce the incidence of precancerous lesions only in the early stages of gastric carcinogenesis. Here, we first survey the etiology and risk factors of GC, and then we analyze the mechanisms underlying tumorigenesis induced by H. pylori, focusing attention on virulence factor CagA, inflammation, oxidative stress, and ErbB2 receptor tyrosine kinase. Moreover, we investigate the relationships between H. pylori eradication therapy and other diseases, considering not only cardia (upper stomach) cancers and Barrett’s esophagus, but also asthma and allergies, through discussion of the “hygiene hypothesis. ” This hypothesis suggests that improved hygiene and antibiotic use in early life reduces microbial exposure, such that the immune response does not become primed, and individuals are not protected against atopic disorders, asthma, and autoimmune diseases. Finally, we overview recent advances to uncover the complex interplay between H. pylori and the gut microbiota during gastric carcinogenesis, as characterized by reduced bacterial diversity and increased microbial dysbiosis. Indeed, it is of particular importance to identify the bacterial taxa of the stomach that might predict the outcome of gastric disease through the stages of Correa’s cascade, to improve prevention and therapy of gastric carcinoma.

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Mass eradication of Helicobacter pylori to reduce gastric cancer incidence and mortality: a long-term cohort study on Matsu Islands

Gut ◽

10.1136/gutjnl-2020-322200 ◽

2020 ◽

pp. gutjnl-2020-322200 ◽

Cited By ~ 1

Author(s):

Tsung-Hsien Chiang ◽

Wei-Jung Chang ◽

Sam Li-Sheng Chen ◽

Amy Ming-Fang Yen ◽

Jean Ching-Yuan Fann ◽

...

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Cancer Incidence ◽

Control Period ◽

Eradication Therapy ◽

Incidence Rates ◽

Long Term Effects ◽

Incidence And Mortality ◽

H Pylori

ObjectiveAlthough mass eradication of Helicobacter pylori has been proposed as a means to eliminate gastric cancer, its long-term effects remain unclear.DesignMass eradication of H. pylori infection was launched in 2004 and continued until 2018 for a high-risk Taiwanese population aged 30 years or older dwelling on Matsu Islands with prevalent H. pylori infection. Test positives for the 13C-urea breath test underwent eradication therapy. We evaluated the effectiveness of the mass eradication in reducing two main outcomes, incidence and mortality rates of gastric cancer, until the end of 2016 and 2018, respectively.ResultsAfter six rounds of mass screening and eradication, the coverage rate reached 85.5% (6512/7616). The referral rate for treatment was 93.5% (4286/4584). The prevalence rates of H. pylori fell from 64.2% to 15.0% with reinfection rates of less than 1% per person-year. The presence and severity of atrophic gastritis and intestinal metaplasia also decreased with time. Compared with the historical control period from 1995 to 2003, the effectiveness in reducing gastric cancer incidence and mortality during the chemoprevention period was 53% (95% CI 30% to 69%, p<0.001) and 25% (95% CI −14% to 51%, p=0.18), respectively. No significant changes were noted in the incidence rates of other digestive tract cancers or the antibiotic resistance rate of H. pylori.ConclusionPopulation-based eradication of H. pylori has significantly reduced gastric cancer incidence with no increase in the likelihood of adverse consequences. A significant reduction in mortality is likely to be achieved with a longer follow-up period.Trial registration numberNCT00155389

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CLINICAL AND MORPHOLOGICAL CHARACTERISTICS OF H. PYLORI-ASSOCIATED GASTRODUODENAL ZONE DISEASES: AGE-RELATED ASPECTS

Ulyanovsk Medico-biological Journal ◽

10.34014/2227-1848-2021-4-89-99 ◽

2021 ◽

pp. 89-99

Author(s):

E.M. Shul'gina ◽

Zh.G. Simonova

Keyword(s):

Helicobacter Pylori ◽

Clinical Picture ◽

Average Length ◽

Eradication Therapy ◽

Young Patients ◽

Morphological Characteristics ◽

Prospective Clinical Study ◽

Age Related ◽

H Pylori ◽

Gastroduodenal Zone

The aim of the paper is to study the clinical and morphological characteristics of H. pylori-associated gastroduodenal zone diseases, depending on patients’ age. Materials and Methods. Three groups of patients of various ages with H. pylori-associated gastroduodenal zone diseases were formed in the course of a prospective clinical study. We studied the clinical picture, and morphological characteristics of the gastroduodenal zone before and after eradication therapy. Average length of the observation period was 172 days. All patients underwent esophagogastroduodenoscopy with biopsy. Results. Severe dyspeptic disorders were diagnosed in all young patients belonging to group 1 (100 %). The dyspeptic index corresponded to a high degree of severity. Morphological changes in the gastric mucosa were more significant in patients with a less pronounced clinical picture (Groups 2 and 3). In group 3, atrophic transformations of the gastric corpus were found in 30.5 %, atrophic transformations of the pylorus – in 11 %, and intestinal metaplasia – in 2.8 % of patients. Unlike young and middle-aged patients with pronounced dyspeptic syndrome, elderly patients were characterized by a low-symptom clinical picture, which was accompanied by morphological gastroduodenal zone transformations with the possible progression. Conclusions. Effective eradication therapy contributes to clinical, endoscopic and morphological remission of the gastroduodenal zone and prevents the progression of the inflammatory cascade. Key words: Helicobacter pylori, gastroduodenal diseases, eradication therapy, age characteristics. Цель исследования – изучить клинико-морфологические особенности H. рylori-ассоциированных заболеваний гастродуоденальной зоны в зависимости от возраста пациентов. Материалы и методы. В процессе проспективного клинического исследования были сформированы три группы пациентов разного возраста, имеющих H. pylori-ассоциированные заболевания гастродуоденальной зоны. Изучали клиническую картину, морфологические особенности гастродуоденальной зоны до и после эрадикационной терапии. Период наблюдения больных составил в среднем 172 дня. Всем пациентам выполнялась ззофагогастродуоденоскопия с биопсией. Результаты. У 100 % пациентов молодого возраста (I группа) установлены выраженные диспепсические расстройства. Диспепсический индекс соответствовал высокой степени тяжести. Для пациентов II и Ш групп при менее выраженной клинической картине морфологические изменения слизистой оболочки желудка оказались более существенны. В старшей группе (Ш группа) атрофические преобразования тела желудка выявлены у 30,5 % пациентов, привратника желудка – у 11 %, кишечная метаплазия – у 2,8 %. В отличие от пациентов молодого и среднего возраста, имеющих выраженный диспепсический синдром, для пациентов пожилого возраста характерна малосимптомная клиническая картина, которая сопровождалась морфологическими преобразованиями гастродуоденальной зоны с возможностью прогрессирования. Выводы. Эффективная эрадикационная терапия способствует достижению клинико-эндоскопической и морфологической ремиссии состояния гастродуоденальной зоны и создает условия для предотвращения прогрессирования воспалительного каскада. Ключевые слова: Helicobacter pylori, заболевания гастродуоденальной зоны, эрадикационная терапия, возрастные особенности.

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Helicobacter pylori Eradication Therapy - Recent Trend in Research

The Korean Journal of Helicobacter and Upper Gastrointestinal Research ◽

10.7704/kjhugr.2019.0051 ◽

2020 ◽

Vol 20 (3) ◽

pp. 210-217

Author(s):

Heung Up Kim

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Antibiotic Resistance ◽

Gastric Mucosa ◽

Drug Exposure ◽

Eradication Therapy ◽

Dual Therapy ◽

Resistance Rate ◽

H Pylori ◽

Selection Of

It is well known that Helicobacter pylori (H. pylori) can cause peptic ulcer, mucosa-associated lymphoid tissue lymphoma, atrophic gastritis, intestinal metaplasia, and ultimately, gastric cancer. Various studies have proven that H. pylori, which attaches to the gastric mucosa, is the cause of gastric cancer and can be eradicated using appropriate antibiotics. Since 2013, Japan has been carrying out national-led eradication treatment of H. pylori for the whole population. However, as drug exposure increases, the resistance rate to some antibiotics increases, and the pattern of antibiotic resistance varies from region to region. Therefore, the development of individualized antimicrobial therapies has become important since antibiotic resistance to H. pylori eradication is a problem worldwide. To help overcome this, remedies such as selection of antibiotics through susceptibility testing, selection of empirical treatment combinations appropriate for the region, dual therapy with high doses of amoxicillin, and the use of rifabutin or sitafloxacin with low antibiotic resistance have been studied. Potassium-competitive acid blocker has been reported to be more potent in inhibiting acid secretion than proton pump inhibitor, and its role in H. pylori eradication is expected. Drug formulations and regimens that are easy to take are being developed to increase compliance. New treatments such as spraying antibiotics directly to the gastric mucosa are being developed and studied.

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Gastric Cancer and Associated Pathogens: Is There Any Association in Moroccan Region?

10.21203/rs.3.rs-1169749/v1 ◽

2021 ◽

Author(s):

Samia Alaoui Boukhris ◽

Mounia El khadir ◽

Safae Karim ◽

Tiatou Souho ◽

Dafr-Allah Benajah ◽

...

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Retrospective Study ◽

Epstein Barr Virus ◽

University Hospital ◽

Cancer Development ◽

Barr Virus ◽

Epstein Barr ◽

H Pylori

Abstract Purpose: Helicobacter pylori, Epstein-Barr virus and human papillomavirus are three pathogens associated with various human cancers. This study aimed to investigate the role of these pathogens in gastric cancer in Moroccan population Methods: For this, a retrospective study has been conducted on participants attending the gastroenterology department of Hassan II University Hospital of Fez. A total of 279 participants were enrolled. H. pylori, EBV and HPV were detected and genotyped by PCR.Results: A significant association has been established between H. pylori, EBV and gastric cancer. 93.4% and 43.3% of gastric cancer cases are related to H. pylori and EBV respectively (p≤0.01). H. pylori-EBV co-infection is responsible of 31.6% of gastric cancer cases (p<0.01). Correlation between pathogens genotypes and gastric cancer shows 55.6% of GC EBV positives are carrying the 30bp deletion in LMP1gene, while 16% of gastric cancers cases are carrying high-risk genotypes of HPV (p=0.21). Conclusion: The obtained results highlight the possible role of co-infection in gastric cancer development.

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Helicobacter pylori eradication therapy to prevent gastric cancer: systematic review and meta-analysis

Gut ◽

10.1136/gutjnl-2020-320839 ◽

2020 ◽

Vol 69 (12) ◽

pp. 2113-2121 ◽

Cited By ~ 13

Author(s):

Alexander Charles Ford ◽

Yuhong Yuan ◽

Paul Moayyedi

Keyword(s):

Gastric Cancer ◽

Systematic Review ◽

Helicobacter Pylori ◽

Endoscopic Mucosal Resection ◽

Meta Analysis ◽

Eradication Therapy ◽

Healthy Individuals ◽

Gastric Neoplasia ◽

H Pylori ◽

Related Mortality

ObjectivesGastric cancer is strongly associated with Helicobacter pylori (H. pylori). We conducted a previous systematic review and meta-analysis that suggested eradication therapy reduced future incidence of gastric cancer, but effect size was uncertain, and there was no reduction in gastric cancer-related mortality. We updated this meta-analysis, as more data has accumulated. We also evaluated impact of eradication therapy on future risk of gastric cancer in patients having endoscopic mucosal resection for gastric neoplasia.DesignWe searched the medical literature through February 2020 to identify randomised controlled trials (RCTs) examining effect of eradication therapy on subsequent occurrence of gastric cancer in healthy H. pylori-positive adults, and in H. pylori-positive patients with gastric neoplasia undergoing endoscopic mucosal resection. The control arm received placebo or no treatment. Follow-up was for ≥2 years. We estimated the relative risk (RR) number needed to treat (NNT), and evaluated the disability-adjusted life-years (DALYs) gained from screening from the meta-analysis.ResultsWe identified 10 RCTs, seven recruited 8323 healthy individuals, and three randomised 1841 patients with gastric neoplasia. In healthy individuals, eradication therapy reduced incidence of gastric cancer (RR=0.54; 95% CI 0.40 to 0.72, NNT=72), and reduced mortality from gastric cancer (RR=0.61; 95% CI 0.40 to 0.92, NNT=135), but did not affect all-cause mortality. These data suggest that 8 743 815 DALYs (95% CI 5 646 173 to 11 847 456) would be gained if population screening and treatment was implemented globally. In patients with gastric neoplasia, eradication therapy also reduced incidence of future gastric cancer (RR=0.49; 95% CI 0.34 to 0.70, NNT=21). Adverse events were incompletely reported.ConclusionThere is moderate evidence to suggest that H. pylori eradication therapy reduces the incidence of gastric cancer in healthy individuals and patients with gastric neoplasia in East Asian countries. There also appears to be a reduction in gastric cancer-related mortality.

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The Prevalence of Multidrug Resistance of Helicobacter pylori and Its Impact on Eradication in Korea from 2017 to 2019: A Single-Center Study

Antibiotics ◽

10.3390/antibiotics9100646 ◽

2020 ◽

Vol 9 (10) ◽

pp. 646

Author(s):

Jae Yong Park ◽

Tae-Seop Shin ◽

Ji Hyun Kim ◽

Hong Jip Yoon ◽

Beom Jin Kim ◽

...

Keyword(s):

Helicobacter Pylori ◽

Multidrug Resistance ◽

Eradication Therapy ◽

University Hospital ◽

Gastric Body ◽

Dilution Method ◽

Agar Dilution Method ◽

Line Treatment ◽

First Line ◽

H Pylori

Antimicrobial resistance is one of the major factors determining the efficacy of Helicobacter pylori eradication therapy. This study aimed to estimate the recent prevalence of multidrug resistance of H. pylori and its impact on eradication in Korea. A total of 174 patients were prospectively enrolled at Chung-Ang University Hospital from 2017 to 2019. H. pylori strains were isolated from the gastric body and antrum. The minimum inhibitory concentrations of antibiotics were determined by the serial twofold agar dilution method. Eradication results were reviewed and analyzed in connection with antibiotic resistance. The prevalence of H. pylori infection was 51.7% (90/174). The culture success rate was 77.8% (70/90). The resistance rates for clarithromycin, metronidazole, amoxicillin, tetracycline, levofloxacin, and moxifloxacin were 28.6% (20/70), 27.1% (19/70), 20.0% (14/70), 18.6% (13/70), 42.9% (30/70), and 42.9% (30/70), respectively. The multidrug resistance (resistance to two or more classes of antimicrobials) rate was 42.9% (30/70). Dual resistance to clarithromycin and metronidazole was confirmed in 8.6% (6/70). Eradication with a first-line treatment was successful in 75% (36/48), and those who received second-line treatment all achieved successful eradication. The rate of multidrug resistance is increasing, and standard triple therapy (STT) is no longer an acceptable first-line option for H. pylori eradication in Korea.

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Helicobacter pylori: Basic Mechanisms to Clinical Cure

Canadian Journal of Gastroenterology ◽

10.1155/1995/210176 ◽

1995 ◽

Vol 9 (2) ◽

pp. 91-95 ◽

Cited By ~ 1

Author(s):

ABR Thomson ◽

CN Williams

Keyword(s):

Gastric Cancer ◽

Duodenal Ulcer ◽

Helicobacter Pylori ◽

Peptic Ulcer ◽

Clinical Cure ◽

Eradication Therapy ◽

Dual Therapy ◽

Quadruple Therapy ◽

Ulcer Disease ◽

H Pylori

Since its rediscovery 10 years ago,Helicobacter pylorihas reshaped our thinking about the course of peptic ulcer disease. Our approach to the patient with a duodenal ulcer has become one of attempting eradication therapy at the time of first diagnosis, in the hope of curing the ulcer disease. Gastric and duodenal ulceration are only two of the manifestations of this chronic antral infection; other complications ofH pyloriinclude gastritis, gastric cancer and possible maltomas. Therapy ofH pyloriinfection is complicated and involves dual therapy with an antibiotic plus a protein pump inhibitor, such as omeprazole 20 mg bid plus amoxicillin 1 g bid for two weeks, triple or quadruple therapy with bismuth, two antibiotics and an H2-receptor antagonist. Vaccination againstH pyloriis on the far horizon.

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