H. pylori-associated pathologic findings among Alaska native patients

ABSTRACT

Helicobacter pylori infection is common among Alaska native (AN) people, however scant gastric histopathologic data is available for this population. This study aimed to characterise gastric histopathology and H. pylori infection among AN people. We enrolled AN adults undergoing upper endoscopy. Gastric biopsy samples were evaluated for pathologic changes, the presence of H. pylori, and the presence of cag pathogenicity island-positive bacteria. Of 432 persons; two persons were diagnosed with gastric adenocarcinoma, two with MALT lymphoma, 40 (10%) with ulcers, and 51 (12%) with intestinal metaplasia. Fifty-five per cent of H. pylori-positive persons had cag pathogenicity island positive bacteria. The gastric antrum had the highest prevalence of acute and chronic moderate–severe gastritis. H. pylori-positive persons were 16 and four times more likely to have moderate–severe acute gastritis and chronic gastritis (p < 0.01), respectively. An intact cag pathogenicity island positive was correlated with moderate–severe acute antral gastritis (53% vs. 31%, p = 0.0003). H. pylori-positive persons were more likely to have moderate–severe acute and chronic gastritis compared to H. pylori-negative persons. Gastritis and intestinal metaplasia were most frequently found in the gastric antrum. Intact cag pathogenicity island positive was correlated with acute antral gastritis and intestinal metaplasia.

KEYWORDS:

• Helicobacter pylori
• Alaska natives
• gastritis
• metaplasia
• cagPAI

Acknowledgements

We would like to acknowledge Julie Morris and Alisa Reasonover for their work culturing the H. pylori organisms.

Disclaimer

The findings and conclusions in this article are those of the authors and do not necessarily represent the official positions of the Centers for Disease Control and Prevention.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This project was funded in part by the Indian Health Service [U26IHS300410]. This study was funded by the Centers for Disease Control and Prevention, a Native American Research Centers for Health (NARCH) grant no.: 1 U26 94 00005.