Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access |
Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc |
Journal website https://gr.elmerpub.com |
Original Article
Volume 18, Number 3, June 2025, pages 119-128
High Seroprevalence of Helicobacter pylori and CagA/VacA Virulence Factors in Northern Central America
Figures
Tables
Guatemala | Honduras | Total | |
---|---|---|---|
aIn Guatemala, all these individuals were 40 - 45 years old. bTobacco use was defined as an adult who has smoked at least 100 cigarettes in his or her lifetime. cAntibiotic exposure was defined as any antibiotics for any reason in the last 6 months. dAlcohol consumption was defined as at least 12 drinks in any one year in lifetime. BMI: body mass index; CagA: cytotoxin-associated gene A; IQR: interquartile range; mamsl: meters above mean sea level; SD: standard deviation; VacA: vacuolating cytotoxin A. | |||
N | 444 | 699 | 1,143 |
Age, mean (SD) | 55.4 (10.7) | 53.4 (16.5) | 54.2 (14.5) |
Age categories | |||
18 - 45 | 90 (20.3%)a | 219 (31.3%) | 309 (27.0%) |
45 - 54 | 138 (31.1%) | 159 (22.7%) | 297 (26.0%) |
55 - 64 | 122 (27.5%) | 147 (21.0%) | 269 (23.5%) |
> 65 | 94 (21.2%) | 174 (24.9%) | 268 (23.4%) |
Sex | |||
Female | 255 (57.4%) | 360 (51.5%) | 615 (53.8%) |
Male | 189 (42.6%) | 339 (48.5%) | 528 (46.2%) |
Rural setting | 272 (61.3%) | 411 (58.8%) | 683 (59.8%) |
Altitude (mamsl), mean (SD) | 1,250.8 (644.6) | 983.4 (209.2) | 1,087.9 (453.7) |
Altitude > 1,000 mamsl | 272 (61.3%) | 369 (53.3%) | 641 (56.4%) |
Occupation | |||
Professional | 9 (2.0%) | 29 (4.1%) | 38 (3.3%) |
Technician | 2 (0.5%) | 37 (5.3%) | 39 (3.4%) |
Artisan or vendor | 182 (41.0%) | 57 (8.2%) | 239 (20.9%) |
Construction | 21 (4.7%) | 23 (3.3%) | 44 (3.8%) |
Agriculture | 54 (12.2%) | 167 (23.9%) | 221 (19.3%) |
Housewife | 144 (32.4%) | 313 (44.8%) | 457 (40.0%) |
Other or not available | 32 (7.2%) | 73 (10.4%) | 105 (9.2%) |
BMI, median (IQR) | 27.4 (23.9 - 30.7) | 24.8 (21.9 - 28.7) | 25.7 (22.7 - 29.7) |
BMI categories | |||
Underweight (BMI < 18.5) | 5 (1.1%) | 31 (4.5%) | 36 (3.2%) |
Normal (18.5 - 24.9) | 148 (33.6%) | 323 (47.3%) | 471 (41.9%) |
Overweight (25 - 29.9) | 155 (35.2%) | 197 (28.8%) | 352 (31.3%) |
Obese (> 30.0) | 132 (30.0%) | 132 (19.3%) | 264 (23.5%) |
Current tobacco smokerb | 196 (44.1%) | 114 (16.3%) | 310 (27.1%) |
Recent use of antibioticsc | 55 (12.4%) | 23 (3.3%) | 78 (6.8%) |
Refrigerator | 200 (45.0%) | 408 (58.4%) | 608 (53.2%) |
Alcohol consumptiond | 321 (72.3%) | 167 (23.9%) | 488 (42.7%) |
Electric or gas stove | 265 (59.7%) | 122 (17.5%) | 387 (33.9%) |
H. pylori serostatus (positive) | 387 (87.2%) | 606 (86.7%) | 993 (86.9%) |
H. pylori active infection | 378 (85.1%) | 571 (81.7%) | 949 (83.0%) |
CagA status (positive) | 402 (90.7%) | 539 (77.1%) | 941 (82.4%) |
VacA status (positive) | 368 (83.1%) | 493 (70.5%) | 861 (75.4%) |
CagA and VacA positive | 397 (89.4%) | 553 (79.1%) | 950 (83.1%) |
H. pylori (-) | H. pylori (+) CagA (-) | H. pylori (+) CagA (+) | P-value | |
---|---|---|---|---|
*P < 0.05. BMI: body mass index; CagA: cytotoxin-associated gene A; mamsl: meters above the mean sea level; SD: standard deviation; VacA: vacuolating cytotoxin A. | ||||
N | 150 | 132 | 861 | |
Age, mean (SD) | 56.6 (15.7) | 54.4 (16.8) | 53.7 (13.8) | 0.08 |
Age categories | 0.13 | |||
18 - 45 | 36 (24.0%) | 39 (29.5%) | 234 (27.2%) | |
45 - 54 | 34 (22.7%) | 28 (21.2%) | 235 (27.3%) | |
55 - 64 | 32 (21.3%) | 31 (23.5%) | 206 (23.9%) | |
> 65 | 48 (32.0%) | 34 (25.8%) | 186 (21.6%) | |
Sex | 0.61 | |||
Female | 78 (52.0%) | 76 (57.6%) | 461 (53.5%) | |
Male | 72 (48.0%) | 56 (42.4%) | 400 (46.5%) | |
Rural setting | 91 (60.7%) | 77 (58.3%) | 515 (59.8%) | 0.92 |
Altitude (mamsl), mean (SD) | 1,079.3 (425.0) | 1,031.2 (338.5) | 1,097.9 (473.1) | 0.29 |
Altitude > 1,000 mamsl | 81 (54.4%) | 82 (63.1%) | 478 (55.8%) | 0.25 |
BMI, median (IQR) | 25.5 (22.1 - 28.9) | 25.4 (22.3 - 30.3) | 25.7 (22.8 - 29.7) | 0.29 |
BMI categories | 0.054 | |||
Underweight (BMI < 18.5) | 10 (6.8%) | 5 (3.8%) | 21 (2.5%) | |
Normal (18.5 - 24.9) | 57 (38.8%) | 56 (43.1%) | 358 (42.3%) | |
Overweight (25 - 29.9) | 54 (36.7%) | 36 (27.7%) | 262 (31.0%) | |
Obese (> 30.0) | 26 (17.7%) | 33 (25.4%) | 205 (24.2%) | |
Current tobacco smoker | 37 (24.7%) | 25 (18.9%) | 248 (28.8%) | 0.046* |
Recent use of antibiotics | 15 (10.0%) | 5 (3.8%) | 58 (6.7%) | 0.12 |
Refrigerator | 87 (58.0%) | 82 (62.1%) | 439 (51.0%) | 0.026* |
Alcohol consumption | 66 (44.0%) | 46 (34.8%) | 376 (43.7%) | 0.15 |
Electric or gas stove | 63 (42.0%) | 34 (25.8%) | 290 (33.7%) | 0.016* |
H. pylori active infection | 27 (18.0%) | 109 (82.6%) | 813 (94.4%) | < 0.001* |
VacA status (positive) | 36 (24.2%) | 53 (40.2%) | 772 (89.7%) | < 0.001* |
H. pylori (-) vs. CagA (+) | CagA (-) vs. CagA (+) | H. pylori (-) and CagA (-) vs. CagA (+) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Unadjusted OR | Adjusted OR | Unadjusted OR | Adjusted OR | Unadjusted OR | Adjusted OR | |||||||
OR (95% CI) | P-value | OR (95% CI) | P-value | OR (95% CI) | P-value | OR (95% CI) | P-value | OR (95% CI) | P-value | OR (95% CI) | P-value | |
Initial univariate analyses were performed with P < 0.1. Variables with a significant association were included in the multivariate analysis. *Variables with P < 0.05 in multivariate analysis. BMI: body mass index; CagA: cytotoxin-associated gene A; CI: confidence interval; mamsl: meters above mean sea level; OR: odds ratio; VacA: vacuolating cytotoxin A. | ||||||||||||
Age | ||||||||||||
45 - 54 | 1.06 (0.64 - 1.76) | 0.81 | 1.12 (0.67 - 1.87) | 0.65 | 1.39 (0.93 - 2.34) | 0.21 | 1.16 (0.67 - 1.98) | 0.59 | 1.21 (0.82 - 1.78) | 0.32 | 1.19 (0.81 - 1.76) | 0.37 |
55 - 64 | 0.99 (0.59 - 1.65) | 0.97 | 1.09 (0.64 - 1.84) | 0.75 | 1.1 (0.66 - 1.83) | 0.69 | 0.89 (0.51 - 1.53) | 0.68 | 1.04 (0.71 - 1.53) | 0.81 | 1.05 (0.71 - 1.55) | 0.80 |
> 65 | 0.59 (0.37 - 0.96) | 0.032 | 0.65 (0.39 - 1.05) | 0.081 | 0.91 (0.55 - 1.50) | 0.72 | 0.79 (0.46 - 1.37) | 0.41 | 0.72 (0.50 - 1.05) | 0.089 | 0.74 (0.51 - 1.08) | 0.13 |
Sex (male) | 0.94 (0.66 - 1.33) | 0.73 | - | - | 1.17 (0.81 - 1.70) | 0.39 | 0.96 (0.61 - 1.50) | 0.88 | 1.04 (0.79 - 1.36) | 0.75 | - | - |
BMI | ||||||||||||
Underweight | 0.33 (0.14 - 0.74) | 0.008 | 0.37 (0.16 - 0.84)* | 0.018* | 0.65 (0.23 - 1.81) | 0.42 | 0.44 (0.22 - 0.88) | 0.021 | 0.47 (0.23 - 0.96)* | 0.039* | ||
Overweight | 0.77 (0.51 - 1.15) | 0.21 | 0.80 (0.52 - 1.21) | 0.29 | 1.13 (0.72 - 1.78) | 0.57 | - | - | 0.91 (0.66 - 1.26) | 0.61 | 0.94 (0.68 - 1.31) | 0.75 |
Obese | 1.25 (0.76 - 2.05) | 0.37 | 1.29 (0.78 - 2.17) | 0.32 | 0.97 (0.61 - 1.54) | 0.90 | 1.09 (0.76 - 1.56) | 0.61 | 1.11 (0.77 - 1.61) | 0.56 | ||
Altitude (> 1,000 mamsl) | 1.06 (0.75 - 1.50) | 0.32 | - | - | 0.73 (0.50 - 1.08) | 0.11 | 0.75 (0.51 - 1.10) | 0.15 | 0.89 (0.68 - 1.17) | 0.44 | ||
Current smoker | 1.24 (0.83 - 1.84) | 0.29 | - | - | 1.73 (1.09 - 2.74) | 0.019 | 1.52 (0.91 - 2.54) | 0.10 | 1.43 (1.05 - 1.97) | 0.026 | 1.44 (1.04 - 1.99)* | 0.028* |
Recent use of antibiotics | 0.65 (0.36 - 1.18) | 0.16 | - | - | 1.83 (0.72 - 4.66) | 0.20 | - | - | 0.94 (0.55 - 1.60) | 0.84 | ||
Refrigerator | 0.75 (0.53 - 1.07) | 0.12 | - | - | 0.63 (0.43 - 0.92) | 0.018 | 0.56 (0.38 - 0.83)* | 0.004* | 0.69 (0.52 - 0.91) | 0.009 | 0.67 (0.50 - 0.89)* | 0.006* |
Alcohol consumption | 0.99 (0.69 - 1.39) | 0.94 | - | - | 1.44 (0.98 - 2.12) | 0.06 | - | - | 1.17 (0.89 - 1.54) | 0.24 | - | - |
Electric or gas stove | 0.70 (0.49 - 0.99) | 0.049 | 0.65 (0.45 - 0.95)* | 0.027* | 1.46 (0.96 - 2.21) | 0.07 | - | - | 0.96 (0.72 - 1.28) | 0.83 | - | - |
Urban Setting | 1.03 (0.72 - 1.47) | 0.84 | - | - | 0.94 (0.64 - 1.36) | 0.74 | - | - | 0.99 (0.75 - 1.30) | 0.94 | - | - |