chronic gastritis (ACG) is characterized by the presence of H. pylori in the gastric epithelium,
known to be one of the first steps that precede progression to gastric
adenocarcinoma. Inactive chronic gastritis (ICG) suggests that the patient has H. pylori gastritis, but this
diagnosis is rarely made in routine histopathology. Clinical
manifestations associated with H. pylori infection are potentially due
to differences in virulence between strains; however, it is unclear if the
progression of ACG to ICG depends on the H.
pylori strain. The aim of this study was to compare the prevalence of the
virulence factors of H. pylori found
in patients with ACG and ICG, and its influence on the development of ICG. A
significant association was observed between H. pylori detection by histological examination and the activity of
gastritis (p < 0.01). Long-term use of proton pump inhibitors (PPI) (>1
year) was reported by 28.6% of the ACG group and 42.5% of the ICG, while no
evidence of association between long-term use of PPI and decreased inflammation
was found in the patients studied. The genes cagA, cagE and virB11 were statistically associated with
ACG (p = 0.01, p < 0.001 and p = 0.002, respectively). In the vacAs1 allele groups, ACG was associated
with the most virulent group (p = 0.0015), while ICG was associated with the
less virulent group (p < 0.001). The rate of co-infection was significantly
higher in ICG than in ACG cases (p = 0.02). In conclusion, this study points to
the role of virulent strains of H. pylori in the non-resolution of gastritis.
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