Corral Juan E, Norwood Dalton A, Alvarez Christian S, Kim Do Han, Montalvan-Sanchez Eleazar E, Rivera-Andrade Alvaro, Ramirez-Zea Manuel, McGlynn Katherine A, Waterboer Tim, Dominguez Ricardo L, Morgan Douglas R
Division of Gastroenterology and Hepatology, Presbyterian Healthcare Services, Albuquerque, NM, USA.
Division of Gastroenterology and Hepatology, Prisma Health, Greenville, SC, USA.
Gastroenterology Res. 2025 Jun;18(3):119-128. doi: 10.14740/gr2036. Epub 2025 Jun 4.
Northern Central America is unique in the Western Hemisphere, with a high incidence of gastric cancer, low/middle-income country (LMIC) status, and a substantial emigration to the United States. The two primary () virulence factors related to carcinogenesis are cytotoxin-associated gene A (CagA) and vacuolating cytotoxin A (VacA). The prevalence of these factors may help delineate gastric cancer risk in the region. We aimed to characterize the seroprevalence and virulence factors in two Central American Countries (Honduras and Guatemala).
Healthy volunteers from Western Honduras and Central-Western Guatemala were recruited and tested for antibodies against 13 antigens using a novel multiplex serology assay. seropositivity was defined as positivity for ≥ 4 antigens, and active infection was defined as positivity for a combination of 2/4 antigens: VacA, GroEl, HcpC, and HP1564, based upon the literature. Multivariate logistic regression models were used to estimate the odds ratios for the association between and CagA positivity.
A total of 1,143 healthy adults were tested using the multiplex serology assay (444 in Guatemala and 699 in Honduras). Mean age was 54.2 ± 14.5 years, 46.2% were male, 60% were from rural settings, and 56% lived > 1,000 meters above sea level. prevalence was 87%, and 83% with active infection. The CagA and VacA seropositivity rates were 82% and 75%, respectively. No significant differences were noted according to country, age group, sex, or rural/urban location. None of the socioeconomic variables were significantly associated with the presence of or CagA.
A high prevalence of , CagA, and VacA is observed in Honduras and Guatemala, with implications for Northern Central America and immigrants from the region. Innovative and resource-appropriate primary and secondary prevention programs are needed.
中美洲北部在西半球独具特色，胃癌发病率高，属于低中收入国家（LMIC），且有大量人口移民至美国。与致癌作用相关的两个主要毒力因子是细胞毒素相关基因A（CagA）和空泡毒素A（VacA）。这些因子的流行情况可能有助于明确该地区的胃癌风险。我们旨在描述中美洲两个国家（洪都拉斯和危地马拉）的血清流行率和毒力因子。
招募来自洪都拉斯西部和危地马拉中西部的健康志愿者，使用一种新型多重血清学检测方法检测其针对13种抗原的抗体。根据文献，血清阳性定义为≥4种抗原呈阳性，活动性感染定义为2/4种抗原（VacA、GroEl、HcpC和HP1564）组合呈阳性。使用多变量逻辑回归模型估计幽门螺杆菌与CagA阳性之间关联的比值比。
共使用幽门螺杆菌多重血清学检测方法检测了1143名健康成年人（危地马拉444名，洪都拉斯699名）。平均年龄为54.2±14.5岁，46.2%为男性，60%来自农村地区，56%居住在海拔1000米以上。幽门螺杆菌流行率为87%，活动性感染率为83%。CagA和VacA血清阳性率分别为82%和75%。根据国家、年龄组、性别或农村/城市位置未发现显著差异。没有社会经济变量与幽门螺杆菌或CagA的存在显著相关。
在洪都拉斯和危地马拉观察到幽门螺杆菌、CagA和VacA的高流行率，这对中美洲北部地区及其移民具有影响。需要创新且资源适宜的一级和二级预防项目。
