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H. pylori  infection causes peptic ulcer, chronic gastritis, mucosa-associated lymphoid tissue lymphoma, and gastric carcinoma. It has several virulence factors such as cytotoxin-associated gene A( cagA ) and the induced by contact with epithelium antigen ( iceA ). We aimed to explore the relationship between  cagA  and  iceA  of  H. pylori  and gastrointestinal diseases. One hundred and eighteen patients who attended Gastrointestinal Endoscopy Unit at Zagazig University Hospitals, Egypt, were included in this study. Two gastric biopsies were collected and evaluated by rapid urease test (RUT) and PCR.  cagA  and  iceA  genes were amplified by PCR. We found that 54 patients (45.76%) were positive by both RUT and PCR.  cagA  and  iceA  genes were present in 57.4% and 46.29% of the studied patients, respectively.  cagA  was the most prevalent gene in gastritis (33.3%) and peptic ulcer (68.7%).  iceA1/iceA2  positive genes were the most prevalent in gastric cancer (75%).  iceA1  gene was present in 38.7% of  cagA  positive cases, but  iceA2  gene was present in 45.2% of  cagA  positive cases.  iceA1/iceA2  positive genes were present in 29% of  cagA  positive cases. In conclusion,  cagA  and  iceA  genes could be used as markers for severe gastrointestinal diseases.  iceA  gene was strongly related to  cagA  gene.

Prevalence of Helicobacter pylori cagA and iceA Genes and Their Association with Gastrointestinal Diseases