THE SEROPREVALENCE OF CAGA-POSITIVE HELICOBACTER-PYLORI STRAINS IN THE SPECTRUM OF GASTROESOPHAGEAL REFLUX DISEASE

Background & Aims, The role of Helicobacter pylori in the pathogenesis of gastroesophageal reflux disease (GERD) is unknown. We determined t he prevalence of cagA-positive (cagA(+)) H. pylori strains in patients with GERD or its complications compared with controls of similar age. Methods: A total of 153 consecutive patients with GERD, Barrett's eso phagus, and Barrett's esophagus complicated by dysplasia or adenocarci noma were compared with 57 controls who underwent upper endoscopy for reasons other than GERD. H. pylori infection and CagA antibody status were determined by histology and enzyme-linked immunosorbent assay. Re sults: H. pylori prevalence was lower (34%) in patients with GERD and its sequelae than in the control group (45.6%)(P = 0.15). Regardless o f the group, increasing age was associated with higher prevalence of H . pylori (P = 0.003). When compared with controls (42.3%), the prevale nce of cagA(+) H. pylori strains decreased (P = 0.008) in patients wit h more severe complications of GERD (GERD, 36.7% [nonerosive GERD, 41. 2%; erosive GERD, 30.8%]; Barrett's esophagus, 13.3%; and Barrett's wi th adenocarcinoma/dysplasia, 0%). Conclusions: Prevalence of H. pylori in patients with GERD and its sequelae was lower but not significantl y different than that of a control group. However, patients carrying c agA(+) strains of H. pylori may be protected against the complications of GERD, especially Barrett's esophagus and its associated dysplasia and adenocarcinoma.