Evaluation of H. pylori - Eradication Triple Therapy in Iraqi Peptic Ulcer Patients according to ABO Phenotypes: a New Study

Infection with H. pylori is an up growing  public health problem that affects approximately 50% of people in industrialized nations, and up to 80% in developing countries. Helicobacter pylori (H. pylori) infection had been identified as the main causes of peptic ulcer disease (PUD). Blood group A phenotype was associated with gastric ulcer (GU) and gastric carcinoma, while blood group O phenotype found to be associated with duodenal ulcer DU predominantly; however, no explanation for this association was received. This study was conducted to, first, determine the relationship between ABO blood groups and H. pylori infection in peptic ulcer patients, and second, to study the response to the two weeks H. pylori eradication triple therapy in peptic ulcer patients carrying different blood groups. A total of  84 patients who presented  with symptoms of PUD and showed positive endoscopic examination of PUD and evidence of H. pylori infection by histology and stool antigen test, were divided into four groups according to ABO blood group phenotype. All H. pylori infected patients received standard H. pylori eradication triple therapy for 14 days duration. Patients were followed up by re- endoscopic examination after 2 months of treatment course. The percentage of H. pylori infection in patients with peptic ulcer disease carrying blood group O was higher than other blood group phenotype. In H. pylori-infected peptic ulcer patients, higher incidence of gastric ulcer (GU) was noticed among blood group A carriers, while higher incidence of duodenal ulcer (DU) was found among blood group O carriers when compare with other blood group phenotypes.  Fourteen days triple therapy showed lower eradication rate in H. pylori infected blood group O peptic ulcer patients, while a higher response to the standard H. pylori eradication triple therapy was found among patients with blood group B phenotype.