Prevalência do Helicobacter pylori e das cepas cagA em portadores de doença inflamatória intestinal atendidos no Hospital Universitário Walter Cantídio em Fortaleza-CE

Abstract

Several studies have investigated the possible protective role of H. pylori infection in inflammatory bowel disease (Crohn's disease and ulcerative colitis), but the results are controversial. This prospective cross-sectional, observational study was conducted between August 2014 and November 2016 to evaluate the prevalence of H. pylori and cagA virulence gene in patients with IBD and in controls treated at the gastroenterology outpatient clinic Of the University Hospital of the Federal University of Ceará - Fortaleza. A total of 182 patients were analyzed, 41 patients with IBD in which 31.7% (13/41) were men and 68.3% (28/41) were women aged 18-72 years and 39.84 ± 14 , 76 (mean ± SD) years; And 141 dyspeptic patients without IBD were 39.9% (55/141) men and 60.1% (86/141) women aged 18-70 years and 40.1 ± 14.20 (mean ± SEM) SD) years, age-matched, who signed a free informed consent form (ICF). All patients were submitted to upper digestive endoscopy (EDA), and biopsies were collected (antrum, body and notch). The detection of H. pylori was done by means of the urease test, the histological analysis and the Polymerase Chain Reaction (PCR) for the ureA gene. PCR was also performed for the cagA virulence gene. Of the 41 patients with IBD, 36.5% (15/41) had Crohn's disease and 63.5% (26/41) ulcerative colitis. On the endoscopic findings, patients with IBD presented gastric erosion in 41.5% (17/41), associated with chronic pangastritis found in 64.3% (9/14) of patients with Crohn's disease; And 56.5% (13/23) in patients with ulcerative colitis, the most frequent histopathological findings were 71.4% (10/14) and 73.9% (17/23); 64.3% (9/14) and 56.5% (13/23) in Crohn's Disease and Ulcerative Colitis, respectively. The bacterium was found in 73.2% (30/41) in the DII group, in the control group this prevalence was 75.1% (106/141). Among the DC and RCU groups, the prevalence of H. pylori was 73.3% (11/15) and 73.1% (19/26), respectively. The cagA gene was positive in 43.9% (15/26) of the DII group and in 76.3% (80/103) of the control, (p = 0.038). The prevalence of H. pylori in patients with IBD and controls was similar. CagA strains were significantly less prevalent in patients with IBD.