Objective: Helicobacter pylori is a significant pathogen associated with gastritis, gastric and duodenal ulcer, gastric cancer, and MALT lymphoma. Since many individuals infected with H. pylori do not develop peptic ulcer and remain asymptomatic, it is thought that other factors could play a role in the development of peptic ulcer disease. Besides H. pylori associated factors such as cytotoxin associated gene (CagA), vacuole-forming cytotoxin gene (VacA), blood group antigen binding adhesion (BabA), Sialil-Lewis X binding (SapA), and IceA found on the pathogenicity island, host factors play an important in the development of H. pylori disease. The urease enzyme and the motility of H. pylori are also important in the pathogenesis of infection. The association between the virulence genes and gastric diseases exhibit geographical difference. Pathogenic and non-pathogenic H. pylori strains can be found in the host, and strains with different genotypes can lead to different clinical presentations. This study was aimed to determine the virulence genes of H. pylori and to investigate the correlation between the type of the virulence genes and endoscopic findings in a group of patients with dyspeptic complaints in the Kocaeli area.

Materials and Methods: A total of 121 patients with dyspeptic complaints were included in the study. Endoscopic tissue biopsies were tested by polymerase chain reaction (PCR) using primers specific to H. pylori 16S tRNA. H. pylori was detected in seventy-eight patients (gastritis, n=40; 20 gastric ulcer, n=20; duodenitis, n=9; normal endoscopic findings, n=9). Virulence genes were determined by classical PCR method. Pearson Chi-square and Fisher's exact tests were used for statistical analysis.

Results: In the H. pylori strains found in the Kocaeli area CagA gene was determined in 70%, S1a/m2 VacA allele in 71.8%, VacA allele s2/m2 in 16.7% of the strains. Though the CagA, VacA s1/m2 genotypes were dominant, a statistically significant correlation was not found between the clinical findings prevalence of these genotypes. IceA1 and IceA2 alleles were found at almost equal rates (24.4% and 26.9%, respectively), while babA2 allele was determined in 6.4% of the strains. A negative correlation was determined between the IceA2 allele and the clinical findings (p= 0.011). IceA1 and babA2 alleles were not found to be statistically associated with clinical findings.

Conclusion: The low virulence gene positivities obtained in this study was attributed to the lack of patients with gastric cancer or precancerous lesions in the study population.