Association of CagA and VacA presence with ulcer and non-ulcer dyspepsia in a Turkish population.

AIM: The mostly known genotypic virulence features of H. pylori are cytotoxin associated gene A (cagA) and Vacuoliting cytotoxin gene A (VacA). We investigated the association of these major virulence factors with ulcer and non-ulcer dyspepsia in our region.

METHODS: One hundred and forty two dyspeptic patients were studied (average age 44.8+/-15.9 years, range 15-87 years, 64 males and 78 females). Antral and corpus biopsies were taken for detecting and genotyping of H. pylori. 107 patients who were H. pylori positive by histological assessment were divided into three groups according to endoscopic findings: Duodenal ulcer (DU), gastric ulcer (GU) and non-ulcer dyspepsia (NUD). The polymerase chain reaction (PCR) was used to detect CagA and VacA genes of H. pylori using specific primers.

RESULTS: H. pylori was isolated from 75.4 % (107/142) of the patients. Of the 107 patients, 66 (61.7 %) were cagA-positive and 82 (76.6 %) were VacA-positive. CagA gene was positively associated with DU and GU (P<0.01, P<0.02), but not with NUD (P>0.05). Although VacA positivity in ulcer patients was higher than that in NUD group, the difference was not statistically significant (P>0.05).

CONCLUSION: There is a significantly positive association between CagA genes and DU and GU. The presence of VacA is not a predictive marker for DU, GU, and NUD in our patients.