Helicobacter pylori (H pylori) infection in Greece: the changing prevalence during a ten-year period and its antigenic profile

BMC Gastroenterol. 2002 May 16:2:11. doi: 10.1186/1471-230x-2-11.

Abstract

Background: To evaluate changes in H pylori infection prevalence in Greece during a ten-year period, and to examine its antigenic profile.

Methods: Three groups of patients were studied. Group O-87: Banked serum samples of 200 consecutive adult outpatients, from the Hepato-Gastroenterology clinic of a teaching hospital at Athens, collected in 1987. Group O-97: Serum samples of 201 similarly selected outpatients from the same Unit, collected in 1997. Group BD-97: Serum samples of 120 consecutive blood donors from the same hospital, collected in 1997. H pylori IgG antibody seroprevalence was studied by a quantitative ELISA. Antigenic profile was studied by western-blot IgG assay, in 62 IgG positive patients of O-97 and BD-97. Results were analyzed by conventional statistics and multivariate regression analysis.

Results: The H pylori seroprevalence increased with age in the three tested groups. In O-97, seroprevalence did not differ from that, in BD-97. On the contrary, there was a significant decrease in seropositivity between O-87 and O-97 (59.5% vs 49.2%, p = 0.039). Multiple regression analysis showed that age over 35 years (OR:3.45, 95% CI:1.59-7.49, p = 0.002) and year of patients' selection - that is 1987 or 1997 - (OR:1.73, 95% CI:1.14-2.65 for 1987, p = 0.010), were independent risk factors of H pylori infection. The seroprevalence of CagA+ and VacA+ strains was 77.4% and 58.5%, respectively, and type I(CagA+/VacA+) strains were significantly more common than type II(CagA-/VacA-) strains (59.7% vs 22.6%, p < 0.001).

Conclusions: During a ten-year period, we found a significant decrease of H pylori infection in Greece and our data support the birth cohort phenomenon as an explanation for the age-dependent increase of H pylori infection. The prevalence of CagA and/or VacA positive strains is relatively high, in a country with low incidence of gastric cancer.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Bacterial / blood
  • Antigens, Bacterial / immunology*
  • Blotting, Western
  • Greece / epidemiology
  • Helicobacter Infections / epidemiology*
  • Helicobacter pylori / isolation & purification*
  • Humans
  • Immunoglobulin G / blood
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prevalence
  • Risk Factors
  • Seroepidemiologic Studies

Substances

  • Antibodies, Bacterial
  • Antigens, Bacterial
  • Immunoglobulin G