Abstract
BackgroundHelicobacter pylori infection is prevalent in Ghana. The development of gastro-duodenal disease is dependent on virulence of the infecting strain, host susceptibility and environmental factors. Helicobacter pylori cagA and vacA strains induce more inflammation, ulceration and oncogenesis. Here, for the first time we present data on H. pylori cagA and vacA genes and their association with gastro-duodenal disease in Ghana. A total of 159 patients with dyspepsia at Korle-Bu Teaching Hospital, Accra, were investigated for H. pylori with urease-CLO, of which 113 (71.1%) were positive. Genomic DNA was extracted from antral biopsies using QIAGEN DNeasy kit. Detection of H. pylori vacA and cagA genes were determined by PCR as previously described.ResultsIn total, 110 (69.2%) vacAs1, 71 (44.7%) vacAm1, 35 (22.0%) vacAm2, 77 (48.4%) cagA-(hydrophilic region) and 109 (68.6%) cagA-(internal duplication region) were detected. In multivariate analysis, duodenal ulcer was more likely than other diagnoses to have detectable cagA-(hydrophilic region) (OR 3.1 CI 1.2–7.9) or vacAs1m1 (OR 6.5 CI 1.2–34.0).ConclusionsMajority of biopsies were colonized with H. pylori harboring both cagA and vacA. H. pylori cagA-(internal duplication region) was more prevalent than cagA-(hydrophilic region). Duodenal ulcer was more likely than other diagnoses to have detectable cagA-(hydrophilic region) or vacAs1m1.
Highlights
Helicobacter pylori infection is prevalent in Ghana
The aim of the study was to utilize a cross-sectional design to characterize H. pylori cytotoxin associated gene A (cagA) and vacuolating cytotoxin (vacA) genes in patients with dyspepsia at the Korle-Bu Teaching Hospital, the main tertiary referral medical centre in Accra serving the majority of the southern half of Ghana
During the study period, 159 patients with gastro-duodenal disease were screened for H. pylori with rapid-urease CLO examination, of which 113 (71.1%) were positive
Summary
The development of gastro-duodenal disease is dependent on virulence of the infecting strain, host susceptibility and environmental factors. Helicobacter pylori cagA and vacA strains induce more inflammation, ulceration and oncogenesis. For the first time we present data on H. pylori cagA and vacA genes and their association with gastro-duodenal disease in Ghana. Infection is universally associated with gastritis, the development of clinical and endoscopic disease is dependent on a number of factors, including the virulence of the infecting strain, the susceptibility of the host and environmental co-factors [4]. Helicobacter pylori strains possessing cagA induce more inflammation, ulceration and oncogenesis when compared with cag-negative strains [5]. Another such virulence factor is the vacuolating cytotoxin (vacA). The bacterial strains inducing more vacuolation, vacAs1 and m1, are closely associated with clinical disease [8]
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