Investigating the potential association of Helicobacter pylori cagA, vacA s1/s2, iceA1, iceA2, babA2, sabA, and oipA genotypes with gastric disease severity.

Abstract

Helicobacter pylori is a pathogen that infects the gastric mucosa of the stomach and can be asymptomatic or lead to disorders ranging from gastric inflammation to gastric adenocarcinoma. This study aimed to find the association of H. pylori virulence factors and their combinations with severity of the disease caused by the bacterium. This cross-sectional study involved 203 patients admitted to the gastroenterology units of the Rizgary Hospital, Erbil, Iraq from July 2021 to May 2022. Biopsy samples were taken, cultured and identified as H. pylori using biochemical and molecular approaches. PCR was employed to amplify virulence genes cagA, vacA s1/s2, iceA1, iceA2, babA2, sabA, and oipA. The most common allelic combination found among the isolates was s2/m1 detected in 33 (36.26%), followed by s1/m1 which was detected in 17 (18.68%). Other genotypes s2/m2 and s1/m2 were recorded in 15 (16.48%) and 12 (13.18%) of the total samples respectively. While the cagA gene was present in 55/91 (60.43%), iceA1 and iceA2 were found in 70 (76.92%) and 54 (59.34%) of the tested isolates respectively. Furthermore, results showed that only four isolates were positive for all virulence factor genes (4.39%). In conclusion, data produced from this study confirmed that the rate of the isolates with all virulence factors was very low. The presence of different virulence factors combination could be used to identify patients who are at high risk for the disease caused by the pathogen and its severity.