PROSPECTIVE STUDY SHOWING THE CORRELATION BETWEEN THE SEVERITY OF HP GASTRITIS AND PRE-NEOPLASTIC LESIONS IN A MOROCCAN POPULATION

Aims Helicobacter pylori (Hp) is a pathogenic bacterium that contributes to an inflammatory reaction of the gastric mucosa. The extent and severity of gastric mucosal inflammation, as well as the occurrence of pre-neoplastic lesions (atrophy and intestinal metaplasia), depend on a number of factors that are related to the bacterium, host, and environmental factors.The aim of this work is to study the gastric lesions associated with Hp infection, and to determine the relationship between bacterial density and the appearance of gastric histological lesions.

Methods We performed a single-centric prospective study from March 2014 and March 2019. We included 406 patients who benefited from high endoscopy and who had Hp infection documented on a histological study of gastric biopsies.

Results The average age of patients was 43.9 years (range, 15 to 87 years). The sex ratio (H/F) was 1.23. Chronic smoking was found in 17.9% of cases. The frequency of antritis and moderate to severe chronic funditis was 78.5% and 40.5% respectively. Moderate to severe activity was noted in 48.5% at the antrum in 21% at the fundus. The incidence of gastric atrophy and intestinal metaplasia was 12.7% and 7.2%, respectively. The density of HP was higher in the antrum than in the fundus (67.2% vs. 26.8% respectively). In univariate analysis, only antral and fundic gastritis activity was significantly associated with bacterial density (OR: 4.3, 95% CI (2.7–6.8) p < 0.001, OR: 5.9. 95% CI (3.5–9.9) p < 0.001 respectively).

Conclusions In our study the density of Helicobacter pylori significantly influences the activity of gastritis. We found no correlation between bacterial density and gastric pre-neoplastic lesions. Other studies with large case series including other factors, including the genetic profile of Helicobacter pylori, are needed.