Impact of Helicobacter pylori virulence markers on clinical outcomes in adult populations

Table 1 List of genes and primer sequences used in the study

Primer	Gene	Primer sequence	Product size (bp)
CAGAF	CagA	5’-GATAACAGGCAAGCTTTTGAGG-3’	349
CAGAR		5’-CTGCAAAAGATTGTTTGGCAGA-3’
VA1-F	VacA signal region	5’-ATGGAAATACAACAAACACAC-3’	259/286 (s1/s2)
VA1-R		5’-CTGCTTGAATGCGCCAAAC-3’
VAG-F	VacA middle region	5’-CAATCTGTCCAATCAAGCGAG-3’	567/642 (m1/m2)
VAG-R		5’-GCGTCTAAATAATTCCAAGG-3’

VacA: Vacuolating cytotoxin A; CagA: Cytotoxin-associated gene A.

Table 2 Demographic characteristics of the study participants, n (%)

Characteristic	Arabs, n = 56	Jews, n = 52	Total, n = 108
Sex
Male	14 (25)	39 (23)	26 (24)
Female	84 (75)	64 (77)	82 (76)
Age, yr
Average (range)	40.93 (18-81)	43.65 (18-88)	42.30 (18-88)
Area of residence
City	21 (37.5)	45 (86.5)	66 (61.1)
Village	35 (62.5)	7 (13.5)	42 (33.9)

Table 3 The prevalence of vacuolating cytotoxin A alleles and cytotoxin-associated gene A vs patient demographics

Characteristic	CagA-positive, n = 24	CagA-negative, n = 84	P	VacA genotype				P
				s1m1	s1m2	s2m1	s2m2
Ethnicity			0.834					0.729
Arabs	12 (50.0)	40 (47.6)		11 (21.2)	11 (21.2)	27 (51.9)	3 (5.8)
Jewish	12 (50.0)	44 (52.4)		8 (14.3)	15 (26.8)	31 (55.4)	2 (3.6)
Sex			0.623					0.214
Male	7 (29.2)	29 (34.5)		6 (16.7)	5 (13.9)	22 (61.1)	3 (8.3)
Female	17 (70.8)	55 (65.5)		13 (18.1)	21 (29.2)	36 (50.0)	2 (2.8)
Residence			0.149					0.055
Village	16 (67.7)	42 (50.0)		8 (13.8)	17 (29.3)	28 (48.3)	5 (8.6)
City	8 (33.3)	42 (50.0)		11 (22.0)	9 (18.0)	30 (60.0)	0 (0)

VacA: Vacuolating cytotoxin A; CagA: Cytotoxin-associated gene A.

Table 4 Associations between virulence factors, patient ethnicity, and disease severity, n (%)

	Disease severity					P value
	Unremarkable, n = 18	Mild, n = 50	Moderate, n = 37	Severe, n = 3	Total, n = 108
Ethnicity						0.002
Arab	5 (27.8)	21 (42.0)	28 (75.7)	2 (66.7)	56 (51.9)
Jewish	13 (72.2)	29 (58.0)	9 (24.3)	1 (33.3)	52 (48.1)
Urease activity
t1	0.32 (0.05)	0.29 (0.06)	0.29 (0.07)	0.30 (0.06)	0.30 (0.06)	0.273
t5	0.32 (0.05)	0.30 (0.05)	0.29 (0.07)	0.34 (0.02)	0.30 (0.06)	0.174
t10	0.32 (0.05)	0.30 (0.06)	0.30 (0.06)	0.35 (0.04)	0.30 (0.06)	0.171
t15	0.33 (0.04)	0.31 (0.05)	0.31 (0.06)	0.36 (0.03)	0.31 (0.05)	0.245
CagA gene						0.534
CagA-	13 (72.2)	41 (82.0)	27 (73.0)	3 (100)	84 (77.8)
CagA+	5 (27.8)	9 (18.0)	10 (27.0)	0 (0)	24 (22.2)
VacA s allele						0.651
VacA s1	5 (27.8)	22 (44.0)	16 (43.2)	1 (33.3)	44 (40.7)
VacA s2	13 (72.2)	28 (56.0)	21 (56.8)	2 (66.7)	64 (59.3)
VacA m Allele						0.652
VacA m1	3 (16.7)	14 (28.0)	7 (18.9)	1 (33.3)	25 (23.1)
VacA m2	15 (83.3)	36 (72.0)	30 (81.1)	2 (66.7)	83 (76.9)
Genotype						0.926
CagA+/s1m1	0 (0)	3 (6.0)	4 (10.8)	0 (0)	7 (6.5)
CagA+/s1m2	1 (5.6)	2 (4.0)	3 (8.1)	0 (0)	6 (5.6)
CagA+/s2m2	2 (11.1)	2 (4.0)	2 (5.4)	0 (0)	6 (5.6)
CagA+/s2m1	1 (5.6)	1 (2.0)	1 (2.7)	0 (0)	3 (2.8)
CagA-/s1m1	2 (11.1)	7 (14.0)	2 (5.4)	1 (33.3)	12 (11.1)
CagA-/s1m2	2 (11.1)	11 (22.0)	7 (18.9)	0 (0)	20 (18.5)
CagA-/s2m2	10 (55.6)	22 (44.0)	18 (48.6)	2 (66.7)	52 (48.1)
CagA-/s2m1	0 (0)	2 (4.0)	0 (0)	0 (0)	2 (1.9)

VacA: Vacuolating cytotoxin A; CagA: Cytotoxin-associated gene A.