Relevance of Underlying Disease and Bacterial <i>vacA</i> and <i>cagA</i> Status on the Efficacy of <i>Helicobacter pylori</i> Eradication

<i>Aim:</i> To study the effects of <i>Helicobacter pylori</i> associated diseases and the bacterial <i>vacA</i> and <i>cagA</i> statuses on the efficacy of <i>H. pylori</i> eradication. <i>Methods:</i> A prospective study in a consecutive series of outpatients of a gastroenterological institution and of a primary practice. A series of 146 <i>H. pylori</i> positive patients with peptic ulcer disease (PUD; n = 40) or nonulcer dyspepsia (NUD; n = 106) were evaluated. <i>H. pylori vacA</i> genotpyes and <i>cagA</i> status were determined directly in gastric biopsy specimens by polymerase chain reaction. The patients were treated with triple-therapy regimens consisting of a proton pump inhibitor and two antibiotics twice daily for 7 days. Reevaluation of <i>H. pylori</i> was determined 4–5 weeks later by endoscopy or ¹³C urea breath test. <i>Results:</i> 123 patients completed the study. In 8 patients, colonization with two or more <i>H. pylori</i> strains was found. The overall cure rate was 84.6% (104/123). The eradication rates were significantly higher in patients with PUD (94.4%, 34/36) than in those with NUD (81.6%, 71/87; p < 0.05). In patients with <i>cagA-</i>positive<i> H. pylori</i> strains, the eradication rate was 89.0% (73/82) as compared with 78.8% (26/33) in those with <i>cagA-</i>negative strains (p = 0.15). The <i>vacA</i> genotype had no effect on the efficacy of <i>H. pylori</i> eradication. <i>Conclusion:</i> Using 1-week triple-therapy regimens, treatment of <i>H. pylori</i> infection is more effective in patients with PUD than in those with NUD.