Abstract
Background: Concomitant H. pylori and T. gondii infections are two widespread diseases transmitted by fecal-oral route. Several studies documented association of both infections in gastritis and peptic ulcer diseases.
Objective: The aim of this work is to evaluate the relation between recurrent gastritis or gastric ulcers and coinfection with H. pylori and T. gondii.
Subjects and Methods: Investigations included upper gastrointestinal tract (GIT) endoscopic biopsy, detailed personal questionnaire, serum detection of anti-cag A and anti-vac A for H. pylori, anti-Toxoplasma IgM and IgG antibodies. Selected cases were from patients attending the Gastroenterology and Hepatology Department of Kafrelsheikh University Hospital. In total, 80 participants were distributed as 32 naive cases, 28 recurrent and 20 with no gastric infections as control. For diagnosis of H. pylori, sandwich ELISA immunoassay (EIA) test was performed to detect H. pylori surface coproantigen in fresh stools taken after endoscopy. In patients' serum samples, IgG for H. pylori cag-A and vac-A antigens, IgM and IgG for T. gondii were detected by ELISA.
Results: Recurrence of H. pylori infection increased in age groups 21-30 and 31-40 years, mainly in males and in those eating junk foods. Severe gastric ulcers appeared in combined H. pylori and T. gondii infections. Recurrent cases showed 71.4% positive H. pylori anti-cag A, 57.1% H. pylori anti-vac A, 35.7% both H. pylori antigens, 57.1% anti-Toxoplasma IgM, and 71.4% anti-Toxoplasma IgG, 35.7% concomitant bacterial and parasitic infection. High IgM positivity rate was recorded in recurrent cases while IgG was recorded in naive cases.
Conclusion: Toxoplasmosis when combined with H. pylori participates in recurrence of the latter, causing higher severity of gastritis and gastric ulcer. Eating junk foods and being middle aged are contributing risk factors.