Helicobacter pylori infection, clarithromycin-resistant genes and CYP2C19 gene polymorphisms in asymptomatic school-age children in Baigou New Town, Baoding City, Hebei Province.

Abstract

Objective: To investigate the prevalence of Helicobacter pylori (Hp) infection, clarithromycin (CAM)-resistant genes and CYP2C19 gene polymorphisms in asymptomatic school-age children in Baigou New Town, Baoding City, Hebei Province, China.

Methods: This retrospective study recruited 1,068 primary school students from Baigou New Town, Baoding City, Hebei Province, China, in November 2023 to screen for Hp infection and detect clarithromycin-resistant genes using stool samples. Additionally, blood samples were collected for CYP2C19 gene polymorphism analysis.

Results: The stool antigen test for Hp yielded a positive rate of 18.4% (197/1,068). Among the 197 Hp-positive patients, 36.5% were resistant to CAM. The polymorphism analysis revealed that, in the 23S rRNA V region, the overall mutation rate was 62.5% for the A2143G site, 77.7% for T2182C, 50% for A2143G and T2182C, 2.7% for A2142C and 1.3% for A2142G. Moreover, the analysis classified the study participants into three CYP2C19 phenotypes (i.e., extensive, intermediate and poor metabolisers; extensive metabolisers (EM), intermediate metabolisers (IM) and poor metabolisers (PM), respectively), and the prevalence was 45.6%, 44.6% and 9.6% for EM, IM and PM, respectively.

Conclusion: The local area showed a high CAM resistance, indicating that CAM is not preferred for Hp eradication. CYP2C19 gene polymorphism analysis revealed that the EM phenotype was highly prevalent. Therefore, a comprehensive analysis of CYP2C19 gene polymorphisms is recommended to identify ideal proton-pump inhibitors for Hp eradication.