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Helicobacter pylori infection and gastroduodenal diseases in Vietnam: a cross-sectional, hospital-based study.

Nguyen TL, Uchida T, Tsukamoto Y, Trinh DT, Ta L, Mai BH, Le SH, Thai KD, Ho DD, Hoang HH, Matsuhisa T, Okimoto T, Kodama M, Murakami K, Fujioka T, Yamaoka Y, Moriyama M - BMC Gastroenterol (2010)

Bottom Line: The prevalence of PU was significantly higher in Hanoi than in Ho Chi Minh.The prevalence of vacA m1, which has been identified as an independent risk factor for PU in Vietnam, was significantly higher among H. pylori isolates from Hanoi than among those from Ho Chi Minh.H. pylori infection is common in Vietnam and is strongly associated with PU, active gastritis, atrophy and intestinal metaplasia. vacA m1 is associated with an increased risk for PU and might contribute to the difference in the prevalence of PU and gastric cancer between Hanoi and Ho Chi Minh.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Molecular Pathology, Oita University, Yufu City, Japan. ngltung@med.oita-u.ac.jp

ABSTRACT

Background: The rate of H. pylori infection in Vietnam is reportedly high, but the spectrum of H. pylori-associated gastroduodenal diseases has not been systematically investigated. Moreover, despite the similarities of ethnicity and diet, the age-standardized incidence rate of gastric cancer in the northern city of Hanoi is higher than that in the southern city of Ho Chi Minh, but the reason for this phenomenon is unknown. The virulence of Vietnamese H. pylori has also not been investigated in detail.

Methods: Individuals undergoing esophagogastroduodenoscopy were randomly recruited. H. pylori infection status was determined based on the combined results of culture, histology, immunohistochemistry, rapid urine test and serum ELISA. Peptic ulcer (PU) and gastroesophageal reflux disease was diagnosed by endoscopy, and chronic gastritis was determined histologically. H. pylori virulence factors were investigated by PCR and sequencing.

Results: Among the examined patients, 65.6% were infected with H. pylori. The prevalence of infection was significantly higher in those over 40 years of age than in those aged ≤40. Chronic gastritis was present in all H. pylori-infected individuals, 83.1% of whom had active gastritis, and 85.3% and 14.7% had atrophy and intestinal metaplasia, respectively. PU was present in 21% of infected patients, whereas its incidence was very low in non-infected individuals. The prevalence of PU was significantly higher in Hanoi than in Ho Chi Minh. The prevalence of vacA m1, which has been identified as an independent risk factor for PU in Vietnam, was significantly higher among H. pylori isolates from Hanoi than among those from Ho Chi Minh.

Conclusions: H. pylori infection is common in Vietnam and is strongly associated with PU, active gastritis, atrophy and intestinal metaplasia. vacA m1 is associated with an increased risk for PU and might contribute to the difference in the prevalence of PU and gastric cancer between Hanoi and Ho Chi Minh.

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Prevalence of gastric atrophy and intestinal metaplasia among H. pylori-infected Vietnamese by age group.
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Figure 1: Prevalence of gastric atrophy and intestinal metaplasia among H. pylori-infected Vietnamese by age group.

Mentions: Chronic gastritis was present in all H. pylori-infected persons, the majority of whom (147/177, 83.1%) had active gastritis, including AP (57.1%), CP (3.4%) and PAN (22.6%). Atrophic gastritis had developed in the majority of them (151/177, 85.3%), even in younger individuals, and its prevalence appeared to increase with age (Figure 1). About 14.7% (26/177) of infected persons had intestinal metaplasia, which was always accompanied by atrophy (Table 1 and Figure 1). The prevalence of antrum-predominant gastritis among H. pylori-infected patients was significantly lower in Hanoi than in Hochiminh, whereas the prevalence of pangastritis in Hanoi was significantly higher than that in Hochiminh. However, there was no significant difference in the prevalences of atrophy and intestinal metaplasia between the two cities (Table 2).


Helicobacter pylori infection and gastroduodenal diseases in Vietnam: a cross-sectional, hospital-based study.

Nguyen TL, Uchida T, Tsukamoto Y, Trinh DT, Ta L, Mai BH, Le SH, Thai KD, Ho DD, Hoang HH, Matsuhisa T, Okimoto T, Kodama M, Murakami K, Fujioka T, Yamaoka Y, Moriyama M - BMC Gastroenterol (2010)

Prevalence of gastric atrophy and intestinal metaplasia among H. pylori-infected Vietnamese by age group.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2959090&req=5

Figure 1: Prevalence of gastric atrophy and intestinal metaplasia among H. pylori-infected Vietnamese by age group.
Mentions: Chronic gastritis was present in all H. pylori-infected persons, the majority of whom (147/177, 83.1%) had active gastritis, including AP (57.1%), CP (3.4%) and PAN (22.6%). Atrophic gastritis had developed in the majority of them (151/177, 85.3%), even in younger individuals, and its prevalence appeared to increase with age (Figure 1). About 14.7% (26/177) of infected persons had intestinal metaplasia, which was always accompanied by atrophy (Table 1 and Figure 1). The prevalence of antrum-predominant gastritis among H. pylori-infected patients was significantly lower in Hanoi than in Hochiminh, whereas the prevalence of pangastritis in Hanoi was significantly higher than that in Hochiminh. However, there was no significant difference in the prevalences of atrophy and intestinal metaplasia between the two cities (Table 2).

Bottom Line: The prevalence of PU was significantly higher in Hanoi than in Ho Chi Minh.The prevalence of vacA m1, which has been identified as an independent risk factor for PU in Vietnam, was significantly higher among H. pylori isolates from Hanoi than among those from Ho Chi Minh.H. pylori infection is common in Vietnam and is strongly associated with PU, active gastritis, atrophy and intestinal metaplasia. vacA m1 is associated with an increased risk for PU and might contribute to the difference in the prevalence of PU and gastric cancer between Hanoi and Ho Chi Minh.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Molecular Pathology, Oita University, Yufu City, Japan. ngltung@med.oita-u.ac.jp

ABSTRACT

Background: The rate of H. pylori infection in Vietnam is reportedly high, but the spectrum of H. pylori-associated gastroduodenal diseases has not been systematically investigated. Moreover, despite the similarities of ethnicity and diet, the age-standardized incidence rate of gastric cancer in the northern city of Hanoi is higher than that in the southern city of Ho Chi Minh, but the reason for this phenomenon is unknown. The virulence of Vietnamese H. pylori has also not been investigated in detail.

Methods: Individuals undergoing esophagogastroduodenoscopy were randomly recruited. H. pylori infection status was determined based on the combined results of culture, histology, immunohistochemistry, rapid urine test and serum ELISA. Peptic ulcer (PU) and gastroesophageal reflux disease was diagnosed by endoscopy, and chronic gastritis was determined histologically. H. pylori virulence factors were investigated by PCR and sequencing.

Results: Among the examined patients, 65.6% were infected with H. pylori. The prevalence of infection was significantly higher in those over 40 years of age than in those aged ≤40. Chronic gastritis was present in all H. pylori-infected individuals, 83.1% of whom had active gastritis, and 85.3% and 14.7% had atrophy and intestinal metaplasia, respectively. PU was present in 21% of infected patients, whereas its incidence was very low in non-infected individuals. The prevalence of PU was significantly higher in Hanoi than in Ho Chi Minh. The prevalence of vacA m1, which has been identified as an independent risk factor for PU in Vietnam, was significantly higher among H. pylori isolates from Hanoi than among those from Ho Chi Minh.

Conclusions: H. pylori infection is common in Vietnam and is strongly associated with PU, active gastritis, atrophy and intestinal metaplasia. vacA m1 is associated with an increased risk for PU and might contribute to the difference in the prevalence of PU and gastric cancer between Hanoi and Ho Chi Minh.

Show MeSH
Related in: MedlinePlus