The cagA, cagE,vacA, dupA, and iceA1 genes of Helicobacter pylori in Sudanese gastritis patients: distribution and relationship with clinical outcomes and histological alterations

Aims: Helicobacter pylori is a gastrointestinal bacterium that causes peptic ulcers and stomach cancer in nearly half of
the world’s population. Many virulence factors influence the outcome of H. pylori related disorders. The purpose of this
study was to see if there was a relationship between H. pylori virulence factors and histological and endoscopic findings
in stomach biopsy specimens from Sudanese gastritis patients.
Methodology and results: In the period between March 2018 and January 2020, a total of 290 gastric biopsies were
taken from patients in Khartoum State hospitals. Histopathology and polymerase chain reaction (PCR) assays were
performed on all specimens. Histological investigation revealed H. pylori in 103/290 (35.5%) samples, while PCR
revealed H. pylori 16S rRNA positivity in 88/290 (30.3%) samples. Eighty-eight positive PCR specimens were subjected
to PCR for genotypic detection of cagA, cagE, vacA, dupA and iceA1 genes. All of strains were vacA positive 100%
(88/88) followed by dupA 50.0% (44/88), cagA 40.9% (36/88), cagE gene 38.6% (34/88) and iceA1 gene was detected
in only 15.9% (14/88). The vacA s1/m1 68.2% (60/88) was the most prevalent vacA subtype.
Conclusion, significance and impact of study: Helicobacter pylori virulence genes were widespread and diversified in
Sudanese gastritis patients. Helicobacter pylori cagA and iceA1 were significantly in association with gastric mucosa
inflammation degree, whereas the dupA gene was found to be associated with the clinical outcomes.