Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 28, 2022; 28(28): 3706-3719
Published online Jul 28, 2022. doi: 10.3748/wjg.v28.i28.3706
Family-based Helicobacter pylori infection status and transmission pattern in central China, and its clinical implications for related disease prevention
Xue-Chun Yu, Qiao-Qiao Shao, Jing Ma, Miao Yu, Chen Zhang, Lei Lei, Yang Zhou, Wen-Chao Chen, Wei Zhang, Xin-Hui Fang, Yuan-Zeng Zhu, Gang Wu, Xue-Mei Wang, Shuang-Yin Han, Pei-Chun Sun, Song-Ze Ding
Xue-Chun Yu, Qiao-Qiao Shao, Jing Ma, Miao Yu, Lei Lei, Xin-Hui Fang, Shuang-Yin Han, Song-Ze Ding, Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
Chen Zhang, Department of Gastroenterology and Hepatology, Henan University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
Yang Zhou, Wen-Chao Chen, Wei Zhang, Yuan-Zeng Zhu, Gang Wu, Pei-Chun Sun, Department of Gastrointestinal Surgery, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
Xue-Mei Wang, Department of Traditional Chinese Medicine, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
Author contributions: Ding SZ, Wu G, Wang XM, Han SY and Sun PC conceived and designed the study; Yu XC, Shao QQ, Zhang C and Yu M searched and screened related literature; Yu XC, Shao QQ, Ma J, Lei L and Zhou Y performed the data extraction and quality assessment; Yu XC, Zhou Y, Chen WC, Zhang W, Fang XH and Zhu YZ analyzed the data; Yu XC and Ding SZ wrote the manuscript; all authors critically revised and approved the final version of the manuscript.
Supported by National Natural Science Foundation of China, No. U1604174; Henan Provincial Government-Health and Family Planning Commission, No. 20170123 and No. SBGJ202002004; and Henan Provincial Government-Health and Family Planning Commission Research Innovative Talents Project, No. 51282.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of People’s Hospital of Zhengzhou University, 2021, No. 53.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Song-Ze Ding, MD, PhD, Professor, Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, No. 7 Weiwu Road, Jin Shui District, Zhengzhou 450003, Henan Province, China. dingsongze@hotmail.com
Received: April 18, 2022
Peer-review started: April 18, 2022
First decision: May 29, 2022
Revised: June 9, 2022
Accepted: June 24, 2022
Article in press: June 24, 2022
Published online: July 28, 2022
Processing time: 99 Days and 13.4 Hours
Abstract
BACKGROUND

Helicobacter pylori (H. pylori) has characteristics of family cluster infection; however, its family-based infection status, related factors, and transmission pattern in central China, a high-risk area for H. pylori infection and gastric cancer, have not been evaluated. We investigated family-based H. pylori infection in healthy households to understand its infection status, related factors, and patterns of transmission for related disease prevention.

AIM

To investigate family-based H. pylori infection status, related factors, and patterns of transmission in healthy households for related disease prevention.

METHODS

Blood samples and survey questionnaires were collected from 282 families including 772 individuals. The recruited families were from 10 selected communities in the greater Zhengzhou area with different living standards, and the family members’ general data, H. pylori infection status, related factors, and transmission pattern were analyzed. H. pylori infection was confirmed primarily by serum H. pylori antibody arrays; if patients previously underwent H. pylori eradication therapy, an additional 13C-urea breath test was performed to obtain their current infection status. Serum gastrin and pepsinogens (PGs) were also analyzed.

RESULTS

Among the 772 individuals examined, H. pylori infection rate was 54.27%. These infected individuals were from 246 families, accounting for 87.23% of all 282 families examined, and 34.55% of these families were infected by the same strains. In 27.24% of infected families, all members were infected, and 68.66% of them were infected with type I strains. Among the 244 families that included both husband and wife, spouse co-infection rate was 34.84%, and in only 17.21% of these spouses, none were infected. The infection rate increased with duration of marriage, but annual household income, history of smoking, history of alcohol consumption, dining location, presence of gastrointestinal symptoms, and family history of gastric disease or GC did not affect infection rates; however, individuals who had a higher education level showed lower infection rates. The levels of gastrin-17, PGI, and PGII were significantly higher, and PGI/II ratio was significantly lower in H. pylori-infected groups than in H. pylori-negative groups.

CONCLUSION

In our study sample from the general public of central China, H. pylori infection rate was 54.27%, but in 87.23% of healthy households, there was at least 1 H. pylori-infected person; in 27.24% of these infected families, all members were infected. Type I H. pylori was the dominant strain in this area. Individuals with a higher education level showed significantly lower infection rates; no other variables affected infection rates.

Keywords: Helicobacter pylori; Atrophic gastritis; Family clustering infection; Gastric cancer; Gastrin; Pepsinogen

Core Tip: Helicobacter pylori (H. pylori) has characteristics of family cluster infection. However, few studies have investigated family-based infection status and pattern of intrafamilial transmission in the general public of central China. In our study, H. pylori infection rate was 54.27%, but in 87.23% of healthy households, there was at least 1 H. pylori-infected person; in 27.24% of these infected families, all members were infected. Type I H. pylori was the dominant strain in this area. Intrafamilial infection status and patterns of transmission represent one important source of H. pylori spread, indicating the urgent need for family-based infection control and related disease prevention.