Long-term assessment of Helicobacter pylori cagA EPIYA motif changes and pathology outcomes in gastric biopsies of dyspeptic patients: 10-year follow-up

Our results showed that 90% and 91% of primary and secondary samples were cagA positive respectively. The most frequent patterns were AB and ABC, and in 52% of patients, notable changes occurred in the motif pattern of cagA. The most frequent gastric pathology was chronic inflammation in both sets of samplings and in 45% of patients, changes in pathology outcomes were reported. A significant association was found between changes in pathology outcomes and gender (P = 0.01), with alterations observed in 24 male patients and 21 female patients, and between changes in pathology outcomes and smoking (P = 0.00). Among those with changes in pathology outcomes, only 18 patients had smoking habits, indicating a potential inverse correlation between smoking and the observed changes. A logistic regression analysis was performed to examine the association between smoking, gender, changes in cagA and alterations in gastric pathology. The finding revealed no significant relationship with smoking (P = 0.978 OR = 1.012) and gender (P = 0.901, OR = 0.950), but identified a significant association with changes in the cagA gene (p = 0.001, OR = 0.296), CONCLUSION: he study highlights substantial heterogeneity in the cagA EPIYA motif patterns in long-term H. pylori colonization and notes an inverse relationship between pathology outcomes and smoking, warranting further investigation.