Resumo

GRANDA, Nashdalish et al. Eficacia de la triple cura y su relación con el genotipo de Helicobacter Pylori Pacientes con dispepsia de la region centroccidental de Venezuela. Gen [online]. 2011, vol.65, n.4, pp.341-348. ISSN 0016-3503.

Introduction: Helicobacter pylori is a bacteria known as causal agent of chronic gastritis, as well as being associated to the development of gastric and duodenal ulcer and related to the development of gastric cancer. Goal: to establish the triple therapy based pharmacological treatment efficacy on patients with dyspepsia and proved H. pylori infection. Materials and methods: It was done an experimental type study, including patients that underwent evaluation on "Dr. Antonio Maria Pineda" University Hospital´s gastroenterology service, in Barquisimeto, between June - October 2009, who presented dyspepsia and fulfilled the inclusion exclusion criteria, they underwent a superior digestive endoscopy with gastric mucous membrane biopsy for fast urease test, histologic evaluation, and polymerase chain reaction (PCR) test aid establishment of cagA and vacA H. pylori genotype. When H. pylori infection was confirmed, a 14 continuous days amoxicillin, clarithromycin and pantoprazole based treatment was prescribed. 8 weeks later the ending of the pharmacological treatment a second superior digestive endoscopy including rapid urease test and histopathological assessment biopsy was performed. Results: 60 patients were included, 76,7% women and 23,4% men, average age 38,3 years old. The H. pylori’s prevalence were 98,3% by rapid urease test and 86,67 by histological assess, the most frequent related symptom before, through an after pharmacological triple therapy was epigastric pain. There was cagA genotype and s1/m1 allelic form predominance by 84, 5% and 55,2% respectively. 56,3% of vacA s1/m1 patients had a positive response to treatment. Triple therapy failed on 56,7% of patients, of them, 66,7% had the s2/m2 vacA´s allelic form and 57,1% had cagA genotype. Conclusion: Triple therapy was ineffective on Helicobacter pylori´s infection treatment for the studied population and having the vacA s1/m1 allelic form is statistically significant for responding to pharmacological triple therapy. Moreover having the vacA s1/m2 allelic form is statistically significant for pharmacological triple therapy failure.

Palavras-chave : Helicobacter pylori´s; H. pylori genotype; vacA; cagA; Dyspepsia; Triple therapy.