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Background  In general, all virulence factors of  Helicobacter pylori  ( H.  pylori) are involved in its infections. However, recent studies have shown that the  homB  gene is one of the virulence genes that affects the severity of the clinical results of this bacterium.    Methods  The main purpose of this study was to investigate the relationship between the presence of  homB  gene in  H. pylori  and the progression of its infection to peptic ulcer and gastric cancer. In the present study, we conducted a systematic search to collect all articles related to the effect of  homB -positive strains on clinical outcomes. Finally, 12 eligible studies according to our criteria were included in this meta-analysis and the effect of  homB  gene on gastric ulcer and gastric cancer diseases was evaluated by summary odds ratio (OR).    Results  Current results showed that the  homB -positive strains significantly increase the risk of peptic ulcer (OR 1.36; 1.07–1.72 with 95% CIs), especially in western countries (OR 1.61; 1.20–2.14 with 95% CIs). Moreover, we observed a positive association between the  homB  gene and risk of gastric cancer (OR 2.16; 1.37–3.40 with 95% CIs). In addition, based on subgroup analysis, it was found that the presence of this gene in  H. pylori  strains increases the risk of gastric cancer in the Asian population (OR 3.71; 1.85–7.45 with 95% CIs).    Conclusions  Overall, in the present study we found that  homB  gene is responsible for the progressing of primary infection to severe complications, in particular peptic ulcer in western countries and gastric cancer in Asian countries.

bmc gastroenterology

Correlation between the geographical origin of Helicobacter pylori homB-positive strains and their clinical outcomes: a systematic review and meta-analysis