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The family Hp infection status in central China is revealed: the co-incidence rate is high, and there is cross-infection between husband and wife

 Last Update: 2022-11-05
 Source: Internet
 Author: User

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Helicobacter pylori (Hp) infection is a major cause of chronic gastritis, peptic ulcer, and gastric cancer, and is closely associated with many parenteral diseases [1-3].

Hp infection is mainly oral-oral or fecal-oral transmission, as well as water sources [4,5], and household transmission is the main source of Hp infection [6-8].

When a person is found positive for Hp, the first impact may be on their own family
.

The latest research shows the epitome
of household Hp infection in central China Henan Province is one of the areas with a high incidence of Hp infection and gastric cancer, and the provincial capital city of Zhengzhou has a population of 12 million, and large-scale household Hp infection and transmission surveys have not yet been carried out.
The factors influencing Hp infection and morbidity are also unclear
.
In view of this, Professor Ding's team selected family members from 10 communities with different living standards in Zhengzhou to conduct blood samples and questionnaires, analyzed the status of household Hp infection, factors associated with Hp infection, Hp genotype and transmission pattern of residents in the area, and evaluated its effect on epidemiological markers of gastric cancer including G17, PGI, PGII and PGR, and the results were published in the World Journal of Gastroenterology in July 2022 [9]
。
The study involved a total of 282 families and 772 family members
.
The results of the study showed that there were 419 cases of Hp infection, and the overall infection rate was 54.
27% (419/772), of which type I strain accounted for 78.
28% (328/419) of the infection cases and type II strain accounted for 21.
7% (91/419).

These infected persons came from 246 families, accounting for 87.
23%
of the 282 families surveyed.

The study further analyzed the rate of Hp infection and genotype in different age groups, and found that type I strain was the dominant strain
for all age groups.
The infection rate among people under 18 years of age was 23.
26% (20/86), with the highest infection rates in the age groups of 51-60 years and 61-70 years old, at 63.
01% (92/146) and 65.
95% (93/141),
respectively.
Compared with the under-18 age group, the infection rate was significantly higher in the age group over 18 years old (p<0.
05), but there was no difference between age groups over 18 years old (p>0.
05) (Figure 1).

Fig.
1 Hp infection status
of 772 participants in different age groups Regarding the risk factors associated with Hp infection, univariate analysis showed that people with tertiary education had lower infection rates, and other factors such as household income, smoking history, drinking history, meal location, gastrointestinal symptoms, and family history of stomach disease or gastric cancer had no effect on infection rates
。
This study also analyzed the status of
Hp infection among couples.
Of the 282 families, 244 had a spouse, and the infection rate of both spouses was 34.
84% (85/244), only 17.
21% (42/244) of couples were not infected, and 47.
95% (117/244) of couples had only one spouse infected
.
Of the 117 families with only 1 spouse infection, 75.
21% (88/117) were infected with type I strain and 24.
79% (29/117) with type II strain
.
In addition, of the 85 families with co-infection of couples, 68.
24% (58/85) were infected with the same type of strains, of which 63.
53% (54/85) were infected with type I strains, 4.
71% (4/85) with type II strains, and 31.
76% (27/85) with both type I and II strains
.
In addition, with the increase in the age of marriage, the infection rate of both spouses increases
significantly.

Among the 51 families with both parents and children younger than 18 years old, the infection rate of children was 23.
08% (6/26) when both parents were infected with Hp; In the absence of Hp in both parents, the infection rate in children was 18.
18% (2/11) (p>0.
05).

When the mother was infected only, the infection rate in children was 45.
45% (5/11); When the father was infected only, there was no infection in children (0/9) (p>0.
05).

The levels of G17, PGI and PGII in patients with Hp infection were significantly higher than those without Hp infection, and the ratio of PGI/II was significantly lower than that in patients without Hp infection (p<0.
05).
<b20>

Research discussion: After infection with Hp, the family may be the first to be affected
The rate of Hp infection varies greatly in different countries and regions [10], and intra-household transmission is one of the most important sources of Hp infection [2,10,11].
Focusing on Hp infection control and management at home is a new way to
reduce the burden of socially-related diseases and stomach cancer.
This study analyzed the Hp infection status of 772 people in 282 families in Zhengzhou, and the results showed that although the overall infection rate was 54.
27%, at least 1 person in the surveyed families up to 87.
23% (246/282) was infected, of which 27.
07% (67/246) of all members of the family were infected; In addition, 34.
55% (85/246) of these households were infected with the same type of strain
.
This study demonstrates the importance of household Hp infection control, which has great public health implications, and shows that household infection is a major source of
Hp transmission.
Therefore, preventing household Hp transmission is essential
to eliminate the source of infection to prevent related diseases.

Of the 244 couples, 34.
84% (85/244) were co-infected and 68.
24% (58/85) were infected with the same strain
.
With the increase of marriage age, the rate of Hp infection of both spouses increased significantly, suggesting cross-infection
between husband and wife.

In this survey, the type I strain accounted for 78.
28% of the infected population, similar to the investigators' previous results on hospitalized patients
.
The levels of G17, PGI and PGII in patients with Hp infection were significantly higher than those without Hp infection, and the PGI/II ratio (PGR) was significantly lower than that in patients without Hp infection (p<0.
05).
<b21> Type I strains and decreased PGR are risk factors for gastric mucosal precancerous lesions and gastric cancer [12,13].

Therefore, these results have important clinical implications
.
Because in healthy Hp infected families, some people find abnormal expression
of gastric cancer markers before presenting to the doctor.
It is unclear whether this group of patients has precancerous gastric mucosa, so further confirmation
by endoscopy may be required.

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The results of this study are a microcosm of the household Hp infection status in central China, and the high infection rate of Hp and the consistent infection of family members in the study reveal the household Hp infection status and transmission pattern, and support the new concept of
Hp infection control and management in the family.
This concept applies not only to Chinese residents, but also to other areas
with high infection rates.

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at the references:[1] Malfertheiner P,et al.
Gut 2022; 71:1724–1762.
doi:10.
1136/gutjnl-2022-327745.
[2]Fallone CA,et al.
Gastroenterology 2016; 151:51-69.
e14.
[3]Ding SZ,et al.
Gut 2022; 71:238-253.
[4]Kato M,et al.
Helicobacter 2019; 24:e12597.
[5]Kivi M,et al.
J Clin Microbiol 2003; 41:5604-5608.
[6]Georgopoulos SD,et al.
Gut 1996; 39:634-638.
[7]Rothenbacher D,et al.
Pediatr Infect Dis J 2002; 21:674-679.
[8]Perry S,et al.
Emerg Infect Dis 2006; 12:1701-1708.
[9]Xue-Chun Yu,et al.
World J Gastroenterol 2022 July 28; 28(28):3706-3719.
[10]Zamani M,et al.
Aliment Pharmacol Ther 2018; 47:868-876.
[11]Sari YS,et al.
World J Gastroenterol 2008; 14:1244-1247.
[12]Matos JI,et al.
Eur J Gastroenterol Hepatol 2013; 25:1431-1441.
[13]Yuan L,et al.
World J Gastroenterol 2020; 26:3673-3685

1, because of the clear carcinogenicity rushed to the hot search, a picture of how to get Helicobacter pylori to the family management

2.
The latest recommendation for the eradication of Helicobacter pylori in special populations, just read this article!

3.
Guidelines consensus| In which cases do you need to eradicate Helicobacter pylori? The new version of the consensus eradication indicators section focuses on interpretation

4.
Is it possible for humans to "eliminate" stomach cancer? Partial interpretation of the new consensus Helicobacter pylori infection and gastric cancer

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