Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University Ramat Aviv, Tel Aviv, Israel.
Hebrew University-Hadassah School of Public Health and Community Medicine, Jerusalem, Israel.
Epidemiol Infect. 2019 Sep 25;147:e276. doi: 10.1017/S0950268819001456.
We examined the prevalence and correlates of Helicobacter pylori (H. pylori) infection according to cytotoxin-associated gene A (CagA) phenotype, a main virulence antigen, among the ethnically diverse population groups of Jerusalem. A cross-sectional study was undertaken in Arab (N = 959) and Jewish (N = 692) adults, randomly selected from Israel's national population registry in age-sex and population strata. Sera were tested for H. pylori immunoglobulin G (IgG) antibodies. Positive samples were tested for virulence IgG antibodies to recombinant CagA protein, by enzyme-linked immunosorbent assay. Multinomial regression models were fitted to examine associations of sociodemographic factors with H. pylori phenotypes. H. pylori IgG antibody sero-prevalence was 83.3% (95% confidence interval (CI) 80.0%-85.5%) and 61.4% (95% CI 57.7%-65.0%) among Arabs and Jews, respectively. Among H. pylori positives, the respective CagA IgG antibody sero-positivity was 42.3% (95% CI 38.9%-45.8%) and 32.5% (95% CI 28.2%-37.1%). Among Jews, being born in the Former Soviet Union, the Middle East and North Africa, vs. Israel and the Americas, was positively associated with CagA sero-positivity. In both populations, sibship size was positively associated with both CagA positive and negative phenotypes; and education was inversely associated. In conclusion, CagA positive and negative infection had similar correlates, suggesting shared sources of these two H. pylori phenotypes.
我们根据细胞毒素相关基因 A（CagA）表型检查了耶路撒冷不同种族人群的幽门螺杆菌（H. pylori）感染的流行率和相关因素，CagA 是主要的毒力抗原。在阿拉伯（N=959）和犹太（N=692）成年人中进行了横断面研究，这些成年人是从以色列全国人口登记处按照年龄、性别和人口分层随机选择的。检测血清中 H. pylori 免疫球蛋白 G（IgG）抗体。通过酶联免疫吸附试验检测阳性样本中重组 CagA 蛋白的毒力 IgG 抗体。使用多项回归模型来检查社会人口因素与 H. pylori 表型的关联。H. pylori IgG 抗体血清阳性率分别为 83.3%（95%置信区间（CI）80.0%-85.5%）和 61.4%（95% CI 57.7%-65.0%），分别在阿拉伯人和犹太人中。在 H. pylori 阳性者中，相应的 CagA IgG 抗体血清阳性率分别为 42.3%（95% CI 38.9%-45.8%）和 32.5%（95% CI 28.2%-37.1%）。在犹太人中，出生在前苏联、中东和北非地区的人，与出生在以色列和美洲的人相比，CagA 血清阳性率呈正相关。在两个群体中，同胞数量与 CagA 阳性和阴性表型均呈正相关，而教育与表型呈负相关。总之，CagA 阳性和阴性感染有相似的相关性，表明这两种 H. pylori 表型有共同的来源。
