PREVALENCE OF HELICOBACTER-ASSOCIATED DISEASES OF GASTROINTESTINAL TRACK IN UZBEKISTAN
Abstract
Background. Treatment of Helicobacter pylori (HP) infection remains a relatively difficult task due to the lack of schemes guaranteeing 100% success.
Objective: to determine the real incidence rate of HP infection and its Cag+ and Cag- strains, as well as the prevalence of antibiotic resistance among the population of Uzbekistan.
Materials and methods of the study included clinical, biochemical, immunological, genetic, and instrumental methods of research. For the diagnosis of HP infection we used the CLO-test for H. pylori detection in the biopsy specimens and the breath test with C13-labeled urea. For determining the resistance to clarithromycin Real-time PCR was carried out in order to detect point mutations A2142G/C and A2143G in functional domain V of the 23S rRNA gene.
Results: It was found that Uzbekistan belongs to regions with a high prevalence of HP infection (80%) among the population. Moreover, it was shown that 84% of the Uzbekistan population has mixed IceA1/ IceA2 genotype of СagA.
According to nosology it was noted that the pathogenic strain СagA+ VacA s1 VacA m2 IceA 1,2 was responsible for the manifestation of peptic ulcer disease. In patients with HP-associated chronic gastritis type b the strain Сag+ VacA s1 VacA m2 and IceA 1 dominated. In patients with HP-associated diseases of the gastrointestinal tract the rate of resistance of HP strains to clarithromycin was 13.3%.
Conclusion: The highest rate of infection with Cag positive strains of HP was found in patients with chronic Helicobacter-associated atrophic and non-atrophic gastritis. The resistance degree of HP infection to clarithromycin in Uzbekistan indicates the necessity to use first-line therapy. Prolongation of eradication therapy up to 14 days allows increasing efficiency of treatment of patients with HP-associated diseases of gastrointestinal tract up to 95%.
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