The clues of the relationship between H. pylori virulance factors and clinical outcomes in children: Relevant clinical indications

Abstract

H. pylori has been defined as class I of human carcinogene. Being dissimilar to the typical symptoms of H. pyloriinfected adults, the symptoms of H. pylori in children are likely mild and unspecific. Recently, the drug-resistant strains of H. pylori are constantly increasing, and the causality between childhood H. pylori and gastric cancer in adulthood has elevated; therefore, clinicians have paid more interest in H. pylori detetion and treament (including asymptomatic children). Since the antibiotic weapons for children (especially for children under 8) are very limited, the challenges in indications for H. pylori treatment in children are part of today’s clinical practice. The aim of the current study is to identify successful treatment indications based on illuminating the link of virulence factors and outcomes. The results show that, the risk of ulcer among CagA(+) H. pyloripositive children is 4 times higher than those infected with CagA(-). The prevalence of CagA(+) and peptic ulcer among the children increases with age (50% in child patients under 5 and nearly 79.2% in child patients over 11 years). The child patients under the age of 5 carrying CagA(+)/vacs1m1m2 and belonging to families with parentsinfected H. pylori have the 6-time higher risk of developing ulcer compared with other groups. Therefore, those patients might be considered to get early treatment