Characteristics and Risk Factors ofHelicobacter pyloriAssociated Gastritis: A Prospective Cross-Sectional Study in Northeast Thailand

Abstract

Background and Aim. Risk factors forHelicobacter pyloriinfection are genetic susceptibility and poor living conditions. This study aimed to investigate theMdm2gene, clarithromycin resistance, and possible risk factors forHelicobacter pyloriinfection.Methods. Risk factors and clinical characteristics were analyzed, including patient demographic data, patient income, personal history, possible source of transmission, patient symptoms, endoscopic findings, patterns of clarithromycin resistance, and patterns ofMdm2SNIP309.Results. Ingestion of pickled fish (OR = 11.27, 95% CI = 4.31–29.45,p<0.0001), salt crab (OR = 8.83, 95% CI = 1.99–39.14,p<0.001), and Papaya salad (OR = 8.73, 95% CI = 4.54–16.79,p<0.01). The prevalence of clarithromycin resistance was 56% (wild type, A2143/2142A, is 23.8%; mutation, A2143/2142CG, is 35.7%; wild type + mutation is 40.5%). The genetic polymorphisms ofMdm2SNIP309 were SNIP309 T/T homozygous in 78%, SNIP309 G/T heterozygous in 19%, and SNIP309 G/G homozygous in 3%.Conclusion. Pickled fish, salt crab, and Papaya salad are positive risk factors. There was high prevalence of clarithromycin resistance. TheMdm2SNIP309 G/G homozygous genotype might be a risk factor for gastric cancer and the fact that it is infrequent in Thailand.