The association between vacA or cagA status and eradication outcome of Helicobacter pylori infection: A meta-analysisReport as inadecuate




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Background

H. pylori virulence factors, especially vacA and cagA are important in gastroduodenal disease pathogenesis and affect cure rates. This meta-analysis aimed to clarify the association between vacA or cagA status and eradication outcome of H. pylori infection.

Methods

A literature search was performed using electronic databases to identify studies. Twenty-six prospective studies were determined eligible. Meta-analytical techniques were conducted to calculate eradication rates and pooled relative ratios RR.

Results

The eradication rate was greater approximately 10% in vacA s1 compared with vacA s2 infected patients, and the pooled RR was 1.164 95%CI: 1.040–1.303, P = 0.008. A significant association existed between vacA s1 and higher eradication rates in Europe RR: 1.203, 95%CI: 1.003–1.442, P = 0.046 and Asia RR: 1.187, 95%CI: 1.028–1.371, P = 0.020, in triple therapy patients RR: 1.175, 95%CI: 1.012–1.365, P = 0.035. Eradication rates were similar for vacA m1 and m2 genotypes RR: 0.981, 95%CI: 0.891–1.080, P = 0.690, whereas they were higher by approximately 8% in cagA-positive compared with cagA-negative infected patients, with a pooled RR of 1.094 95%CI: 1.025–1.168, P = 0.007. A significant association existed between cagA-positive and increased eradication rates in Europe RR: 1.138, 95%CI: 1.000–1.295, P = 0.049 and Asia RR: 1.118, 95%CI: 1.051–1.190, P<0.001, in using PCR RR: 1.232, 95%CI: 1.142–1.329, P<0.001 and protein chips RR: 1.200, 95%CI: 1.060–1.359, P = 0.004, in triple therapy patients RR: 1.090, 95%CI: 1.006–1.181, P = 0.034.

Conclusions

Evidence indicates that infection with vacA s1, cagA-positive strains, but not vacA s2, cagA-negative, is more conducive to H. pylori eradication.



Author: Dan Wang, Qiuping Li, Yuehua Gong , Yuan Yuan

Source: http://plos.srce.hr/



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