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Background  Infection with  cagA -positive,  cagA  EPIYA motif ABD type, and  vacA  s1, m1, and i1 genotype strains of  Helicobacter pylori  is associated with an exacerbated inflammatory response and increased risk of gastroduodenal diseases. However, it is unclear whether the prevalence and virulence factor genotypes found in Southeast Asia are similar to those in Western countries. Here, we examined the  cagA  status and prevalence of  cagA  EPIYA motifs and  vacA  genotypes among  H. pylori  strains found in Southeast Asia and examined their association with gastroduodenal disease.    Methods  To determine the  cagA  status,  cagA  EPIYA motifs, and  vacA  genotypes of  H. pylori , we conducted meta-analyses of 13 previous reports for 1,281  H. pylori  strains detected from several Southeast Asian countries.    Results  The respective frequencies of  cagA -positive and  vacA  s1, m1, and i1 genotypes among examined subjects were 93% (1,056/1,133), 98% (1,010/1,033), 58% (581/1,009), and 96% (248/259), respectively. Stratification showed significant variation in the frequencies of  cagA  status and  vacA  genotypes among countries and the individual races residing within each respective country. The frequency of the  vacA  m-region genotype in patients infected with East Asian-type strains differed significantly between the northern and southern areas of Vietnam ( p  < 0.001). Infection with  vacA  m1 type or  cagA -positive strains was associated with an increased risk of peptic ulcer disease (odds ratio: 1.46, 95%CI: 1.01-2.12, p = 0.046 and 2.83, 1.50-5.34,  p  = 0.001, respectively) in the examined Southeast Asian populations.    Conclusions  Both Western- and East Asian-type strains of  H. pylori  are found in Southeast Asia and are predominantly  cagA -positive and  vacA  s1 type. In Southeast Asia, patients infected with  vacA  m1 type or  cagA -positive strains have an increased risk of peptic ulcer disease. Thus, testing for this genotype and the presence of  cagA  may have clinical usefulness.

bmc infectious diseases

Role of Helicobacter pylori cagA EPIYA motif and vacAgenotypes for the development of gastrointestinal diseases in Southeast Asian countries: a meta-analysis