EFFECT OF HELICOBACTER-PYLORI ERADICATION ON GASTRITIS IN RELATION TOCAGA - A PROSPECTIVE 1-YEAR FOLLOW-UP-STUDY

Background & Aims: Whether Helicobacter pylori eradication resolves in testinal metaplasia and atrophy and whether infection with cagA(+) H. pylori is related to a specific clinical outcome are not known. The ai m of this study was to investigate the role of H. pylori eradication o n the course of intestinal metaplasia (IM) and atrophy in relation to cagA. Methods: In a large prospective study, the cag4 status of H. pyl ori isolated from consecutive dyspeptic patients was related to clinic al outcome before and 1 year after successful eradication of H. pylori . At pretreatment and 4-6 weeks and on average 1 year after eradicatio n therapy, the degree of gastritis and the status of H. pylori were as sessed by culture and histopathology. Results: Specimens of cagA(+) H. pylori were recovered from 122 of 155 (79%) patients infected with H. pylori. Pretreatment degrees of gastritis activity, superficial epith elial damage, IM, and atrophy were significantly greater in patients i nfected with cagA(+) H. pylori (P < 0.001). After successful eradicati on of H. pylori, a significant improvement of activity of gastritis an d superficial epithelial damage occurred (P < 0.001), but the degree o f IM and atrophy did not change, irrespective of the cagA status. Conc lusions: The usefulness of H. pylori eradication to revert precancerou s lesions such as IM and atrophy after 1-year follow-up is questionabl e.