Prevalence of the cagA Virulence Factor Varies by Race among H. pylori-infected Patients Undergoing Upper Endoscopy

Meira Epplein; Shannon J McCall; Frances Wang; Priya Alagesan; HannahSofia Brown; Joseph Wawrzynski; Caroline Labriola; Rachel Zuzul; Christian Cook; Melanie Dillon; Terry Hyslop; Steven R Patierno; Nina R Salama; Katherine S Garman

doi:10.14309/ctg.0000000000000713

Prevalence of the cagA Virulence Factor Varies by Race among H. pylori-infected Patients Undergoing Upper Endoscopy

Clin Transl Gastroenterol. 2024 May 14. doi: 10.14309/ctg.0000000000000713. Online ahead of print.

Authors

Meira Epplein^{1

2}, Shannon J McCall³, Frances Wang⁴, Priya Alagesan⁵, HannahSofia Brown⁶, Joseph Wawrzynski⁷, Caroline Labriola⁵, Rachel Zuzul⁵, Christian Cook⁸, Melanie Dillon⁹, Terry Hyslop^{1

4

10}, Steven R Patierno^{1

6}, Nina R Salama⁹, Katherine S Garman^{1

6

7}

Affiliations

¹ Cancer Risk, Detection, and Interception Program, Duke Cancer Institute, Durham, NC.
² Department of Population Health Sciences, Duke University, Durham, NC.
³ Department of Pathology, Duke University, Durham, NC.
⁴ Department of Biostatistics & Bioinformatics, Duke University, Durham, NC.
⁵ School of Medicine, Duke University, Durham, NC.
⁶ Department of Medicine, Duke University, Durham, NC.
⁷ Division of Gastroenterology, Department of Medicine, Duke University, Durham, NC.
⁸ School of Medicine, University of North Carolina, Chapel Hill, NC.
⁹ Division of Human Biology, Fred Hutchinson Cancer Center, Seattle, WA.
¹⁰ Division of Biostatistics, Thomas Jefferson University, Philadelphia, PA.

PMID: 38742743
DOI: 10.14309/ctg.0000000000000713

Abstract

Introduction: We designed a race-conscious study to assess the presence of Helicobacter pylori (Hp) virulence factor cagA in a retrospective cohort of patients with active Hp infection.

Methods: We compared cagA status by race in gastric tissue samples from 473 patients diagnosed with active Hp infection from 2015-2019.

Results: Hp+ Black patients were two times more likely to be cagA+ than Hp+ White patients (82% vs. 36%, P < .0001).

Discussion: Presence of cagA is common among endoscopy patients with active Hp infection; appropriate testing and treatment of Hp can both reduce gastric cancer risk and address health disparities.

Abstract

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