الفهرس 
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Abstract
Helicobacter pylori is a gram-negative bacteria etiologically involved in peptic ulcer disease, gastric carcinoma as well as functional dyspepsia. Although infection with H. pylori almost always results in chronic active gastritis, only a fraction of those infected develop clinical disease. While this phenomenon remains unexplained, host genetics, host immune response, and the relationship of the host response to bacterial virulence factors appear to play critical roles. A tremendous number of studies are investigating the roles of putative virulence factors of H. pylori, and the best studied are the cagA and VacA gene. CagA and VacA producing strains are reported to be related to severe clinical outcomes, especially in Western countries. In developing countries especially in African setting, the prevalence and associated pathology of such putative virulent gene (CagA and VacA) is not well defined.
The present work was planned to study the relationship between Helicobacter pylori CagA and VacA and dyspepsia associated with peptic ulcer.
A total number of 50 (mean age 45.88±9.34, male/female 25/25) Helicobacter pylori positive patients and control volunteers were recruited and distributed as Summary & conclusion 77
follows:
group I: Patients with dyspeptic symptoms (50) :
All patients are positive peptic ulcer by upper GIT endoscopy.
All patients will be tested to H. pylori CagA and VacA to evaluate H.pylori virulent strains.
group II: dyspeptic volunteers (24).
All patients and control were subjected to:
- Full history taking
- Complete clinical examination
- Routine Laboratory investigations
- CagA and VacA assay .
The results of the study were tabulated, statistically analyzed and graphically represented.
Overall prevalence of peptic ulcer (84%) males and (92%) females. The gender distribution of H. pylori CagA and VacA of the studied patients ,in gastric ulcer CagA and VacA was found in 34 patients, they were 14 patients (56%) males and 20 patients (80%) females. They showed a statistically significant difference (P <0.05) between both males and females. In duodenal ulcer CagA and VacA was Summary & conclusion 78
found in 10 patients, they were 7 patients (28%) males and 3 patients (12.0%) females. They showed a statistically significant difference (P <0.05) between both males and females. They showed also negative CagA and VacA was found in 6 patients , they were 4 patients (16.0%) males and 2 patients (8.0%) females. They also showed a statistically significant difference (P <0.05) between both males and females.
Finally, infection with CagA and VacA positive Helicobacter pylori strains may be associated with more sever gastroduodenal pathology especially gastric and duodenal ulcers. CagA and VacA gene help in identifying patients at risk for development of peptic ulcer especially in dyspeptic patients.