Helicobacter pylori
(
H. pylori
) is a gram-negative which can cause several gastroduodenal diseases, including gastritis and peptic ulcer disease (PUD).
H. pylori
specific genotypes have been related to increased occurrence of gastritis and PUD. The aim of this study was to investigate the clinical relevance of the major virulence factors of
H
.
pylori
with clinical outcomes and histological parameters in Iranian patients. Totally, 200 subjects with PUD and gastritis disease who underwent gastroduodenal endoscopy were enrolled in this study. The presence of the
cagA
,
vacA
,
oipA
,
babA2
, and
iceA
genes in antral gastric biopsy specimens were determined by polymerase chain reaction (PCR) and the results were compared with clinical outcomes and histological parameters. The frequency of
babA2
+
,
oipA
+
,
vacA s1/m2
, and
vacA m2
genes was significantly higher in patients with peptic ulcer disease compared with patients with gastritis. In contrast, the frequency of
vacA s1/m1
gene was significantly higher in gastritis subjects than PUD subjects. The high-density scores of
H. pylori
were strongly associated with
iceA1
¯
, babA2
+
, and
oipA
+
genes. Additionally, the high polymorphonuclear cell infiltration and high mononuclear cell infiltration scores were strongly associated with the
cagA
+
,
iceA1
¯
,
oipA
+
genes and
cagA
+
, babA2
+
,
oipA
+
genes, respectively. Our study indicated that the
vacA
,
babA2
, and
oipA
virulence factors are related to a higher risk of PUD in subjects with
H. pylori
-infection. Infection with these strains was associated with a more severe gastropathy.