Genotyping of Helicobacter pylori shows high diversity of strains circulating in central Vietnam

Phan, Trung Nam; Santona, Antonella; Tran, Van Huy; Tran, Thi Ngoc Anh; Lê, Văn An; Cappuccinelli, Pietro Antonio; Rubino, Salvatore; Paglietti, Bianca

doi:10.1016/j.meegid.2017.04.014

Cited by 11 publications

(9 citation statements)

References 43 publications

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“…The explanation of the diversity in FAT accuracy as a test which uses antigens is most likely to be linked with the diversity of genome and virulence of H. pylori strains across the world [ 32 ]. Emerging data from studies predominantly conducted in Asian populations unequivocally show large geographical variations in the distribution of H. pylori strains [ 33 , 34 ]. Although extensive work has been done to elucidate how genetic diversity is related to human cancer, little is known about the effect of genetic diversity on the performance of stool antigen test for the diagnosis of H. pylori [ 35 ] .…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Helicobacter pylori eradication regimens in Rwanda: a randomized controlled trial

et al. 2018

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BackgroundSuccessful H. pylori treatment requires the knowledge of local antimicrobial resistance. Data on the efficacy of H. pylori eradication regimens available in sub-Saharan Africa are scant, hence the optimal treatment is unknown.Our goals were to determine the efficacy of available regimens in Rwanda as well as evaluate the effect of treatment on health-related quality of life (HRQoL) in patients undergoing esophagogastroduodenoscopy.MethodsThis is a randomized controlled trial conducted from November 2015 to October 2016 at a tertiary hospital in Rwanda. Enrollees were 299 patients (35% male, age 42 ± 16 years (mean ± SD)) who had a positive modified rapid urease test on endoscopic biopsies. After a fecal antigen test (FAT) and HRQoL assessment by the Short Form Nepean Dyspepsia Index (SF-NDI) questionnaire, patients were randomized 1:1:1:1 to either a triple therapy combining omeprazole, amoxicillin and one of clarithromycin/ciprofloxacin/metronidazole or a quadruple therapy combining omeprazole, amoxicillin, ciprofloxacin and doxycycline. All therapies were given for a duration of 10 days. The outcome measures were the persistence of positive FAT (treatment failure) 4 to 6 weeks after treatment and change in HRQoL scores.ResultsThe treatment success rate was 80% in the total population and 78% in patients with a history of prior triple therapy. Significant improvement in HRQoL in the total group (HRQoL mean scores before and after treatment respectively: 76 ± 11 and 32 ± 11, p < 0.001) and the group with functional dyspepsia (HRQoL mean scores before and after treatment respectively: 73 ± 11 and 30 ± 9, P < 0.001) was observed across all treatment groups.Using clarithromycin based triple therapy (standard of care) as a reference, the group treated with metronidazole had worse HRQoL (p = 0.012) and had a trend towards worse treatment outcome (p = 0.086) compared to the ciprofloxacin based combination therapies.ConclusionClarithromycin and ciprofloxacin based combination therapies are effective and safe to use alternatively for H. pylori eradication and improve HRQoL. Among the regimens studied, metronidazole based triple therapy is likely to be clinically inferior.Trial registrationThe clinical trial was retrospectively registered (PACTR201804003257400) with the Pan African Clinical Trial Registry database, on April 6th, 2018 in South Africa.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Helicobacter pylori eradication regimens in Rwanda: a randomized controlled trial

et al. 2018

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“…This study revealed a lower frequency of cagA than previous reports on Vietnamese H. pylori [ 52 – 55 ] which may contribute to the lower rates of gastric ulcer and gastric cancer observed in Vietnam. In dyspeptic patients from central Vietnam, the frequency of cagA + strains was 84% [ 54 ]. In H. pylori strains from Southern Vietnam with gastric cancer and peptic ulcer, all strains were cagA positive [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

“…The most frequent EPIYA motif found in our isolates was ABD (96.6%; 63/66), which is similar to previous reports from Vietnamese patients with the gastric disease [ 52 , 55 ]. However, these frequencies were different in central Vietnam isolates, where vacA s1m1/ cagA + genotype was detected in 64.86% (48/74) of isolates and the cagA –ABD motif was found in a lower proportion (91%) [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

The endemic Helicobacter pylori population in Southern Vietnam has both South East Asian and European origins

Nguyen

Nguyen-Hoang

et al. 2021

Gut Pathog

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Background The burden of Helicobacter pylori-induced gastric cancer varies based on predominant H. pylori population in various geographical regions. Vietnam is a high H. pylori burden country with the highest age-standardized incidence rate of gastric cancer (16.3 cases/100,000 for both sexes) in Southeast Asia, despite this data on the H. pylori population is scanty. We examined the global context of the endemic H. pylori population in Vietnam and present a contextual and comparative genomics analysis of 83 H. pylori isolates from patients in Vietnam. Results There are at least two major H. pylori populations are circulating in symptomatic Vietnamese patients. The majority of the isolates (~ 80%, 66/83) belong to the hspEastAsia and the remaining belong to hpEurope population (~ 20%, 17/83). In total, 66 isolates (66/83) were cagA positive, 64 were hspEastAsia isolates and two were hpEurope isolates. Examination of the second repeat region revealed that most of the cagA genes were ABD type (63/66; 61 were hspEastAsia isolates and two were hpEurope isolates). The remaining three isolates (all from hspEastAsia isolates) were ABC or ABCC types. We also detected that 4.5% (3/66) cagA gene from hspEastAsia isolates contained EPIYA-like sequences, ESIYA at EPIYA-B segments. Analysis of the vacA allelic type revealed 98.8% (82/83) and 41% (34/83) of the strains harboured the s1 and m1 allelic variant, respectively; 34/83 carried both s1m1 alleles. The most frequent genotypes among the cagA positive isolates were vacA s1m1/cagA + and vacA s1m2/cagA + , accounting for 51.5% (34/66) and 48.5% (32/66) of the isolates, respectively. Conclusions There are two predominant lineages of H. pylori circulating in Vietnam; most of the isolates belong to the hspEastAsia population. The hpEurope population is further divided into two smaller clusters.

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“…[ 10 ] East Asian strains increase the risk of gastric ulcer and cancer, although the number of EPIYA-C motifs within the Western-type cagA has been related to an increased risk of stomach cancer. [ 11 ]…”

Section: Introductionmentioning

confidence: 99%

EPIYA Motif Genetic Characterization from Helicobacter pylori Isolates in Distinct Geographical Regions of Iran

Moghim

Estaji

Esfahani

et al. 2022

Advanced Biomedical Research

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Background: This study aimed to determine the current EPIYA motifs of the cag A gene in Helicobacter pylori isolates from patients with gastric disorders, and evaluate the association between these patterns and the clinical outcome of H. pylori infection in different geographical regions of Iran. Materials and Methods: We examined 150 patients with gastrointestinal disorders from the central and eastern regions of Iran. The detection of H. pylori and screening of cag A was performed by polymerase chain reaction (PCR). The pattern of the motifs was determined by PCR followed by sequencing. Results: The overall prevalence of H. pylori was 66.3% in eastern (Mashad) and 50.6% in the central (Isfahan) part of Iran. The frequency of cag A-positive strains in Mashad and Isfahan were 63.4% and 56.7%, respectively. The pattern of EPIYA motif was as follows: 43 (79.6%) ABC, 7 (12.9%) AB, 4 (7.4%) ABCC, and one (1.9%) ABCCC. We also identified a novel EPIYA C sequence motif which showed association with gastric cancer (GC). The relationship between the frequency of specific EPIYA motifs and GC was statistically significant ( P < 0.05). Conclusions: This is the first report for the determination of the cag A EPIYA motif of H. pylori in the Northeast and center of Iran. The prevalence of cag A positive H. pylori between the two regions was significant ( P ≤ 0.05). All isolates of the H. pylori cag A were western type (ABC). The increase in the number of EPIYA-C repeats was associated with GC ( P ≤ 0.01).

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Genotyping of Helicobacter pylori shows high diversity of strains circulating in central Vietnam

Cited by 11 publications

References 43 publications

Efficacy of Helicobacter pylori eradication regimens in Rwanda: a randomized controlled trial

Efficacy of Helicobacter pylori eradication regimens in Rwanda: a randomized controlled trial

The endemic Helicobacter pylori population in Southern Vietnam has both South East Asian and European origins

EPIYA Motif Genetic Characterization from Helicobacter pylori Isolates in Distinct Geographical Regions of Iran

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