Prevalence of Helicobacter pylori virulence genes among Iranian infected patients: a systematic review and meta-analysis

Introduction: Helicobacter pylori infection as the worldwide problem is related to many gastrointestinal disorders. Because of antithesis results among different articles; we systematically reviewed articles about the prevalence of H. pylori virulence factors among different diseases (gastritis, gastric cancer, nonulcer disease, peptic ulcer disease, duodenal ulcer) in different regions of Iran. Methods: We used the Preferred Reporting Items for Systematic Review and Meta-Analysis statement for reporting systematic review and meta-analysis of this study in national and international databases. We searched the cagA, vacA, oipA, babA, iceA, dupA prevalence among infected patients in Iran. We used Newcastle--Ottawa quality for assessing the quality of studies in meta-analyses. Due to significant heterogeneity of the results, random effects model to calculate pooled prevalence estimates with 95% confidence intervals, weighted by study size. Results: Among 1106 reports screened, 28 related articles were eligible for meta-analysis. The pooled prevalence (95% confidence interval) of cagA, vacA, oipA, babA, iceA1, iceA2, dupA were estimated as 62% (21--95), 71.2% (38-82), 71% (13-99), 61.6% (3-96), 36.2% (12-90), 26.2% (13-37), 40.8% (12-55), respectively. Discussion: The frequency of virulence factor genes among H. pylori strains isolated in Iranian patients to be more frequently associated with the gastrointestinal disease compared with the other countries and these data can be considered in development of eradication strategies.