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

• Published in: PloS one 2017-05, Vol.12 (5), p.e0177455-e0177455
• Main Authors: Wang, Dan, Li, Qiuping, Gong, Yuehua, Yuan, Yuan
• Format: Article
• Language: English
• Subjects: Antibiotics; Antigens, Bacterial - genetics; Antigens, Bacterial - metabolism; Bacterial Proteins - genetics; Bacterial Proteins - metabolism; Biology and Life Sciences; Care and treatment; Chips; Education; Eradication; Gastric cancer; Gastroenterology; Gastrointestinal diseases; Genotype; Genotypes; Helicobacter infections; Helicobacter Infections - metabolism; Helicobacter pylori; Helicobacter pylori - genetics; Helicobacter pylori - pathogenicity; Helicobacter pylori - physiology; Hospitals; Humans; Infections; Laboratories; Medicine and Health Sciences; Meta-analysis; Pathogenesis; Patients; Physical Sciences; Polymerase chain reaction; Prevention; Prospective Studies; Research and Analysis Methods; Statistical analysis; Stomach cancer; Studies; Surgery; Therapy; Ulcers; Virulence; Virulence factors
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0177455

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. 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). 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