Acute Renal Failure; Assessment of Risk Factors Among Postoperative Patients in A Tertiary Care Hospital in Sri Lanka

Abstract

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Aims: This study aimed to assess association of selected HLA (Human Leukocyte antigen) alleles; HLA-DQA1*0102, HLA-DQA1*0103, HLA-DQBP0301 with H. pylori infection among a Sri Lankan dyspeptic patient population. Methods: Gastric biopsy specimens from 100 patients who underwent upper gastrointestinal endoscopy at a tertiary care hospital were investigated in this study. Presence of H. pylori was confirmed using histology and PCR. Histological interpretation was done using Modified ‘Sydney system’. The presence of HLA alleles and selected virulence genes of H. pylori; cagA, vacA and babA2, were determined using Polymerase Chain Reaction (PCR). Results: Mfld to moderate inflammation was observed in 96 biopsy specimens. Alleles, HLA-DQA1*0102, HLA-DQA1*0103, HLA-DQB1*0301 was seen 39%, 31% and 20% respectively in the 100 dyspeptic patients. Out of 25 H. pylori confirmed patients (by PCR or histology), 56% (14/25), 36% (9/25) and 12% (3/25) were positive for HLA-DQA1*0102, HLA-DQA1*0103 and HLADQB1*0301 alleles respectively. Out of 22 H. pylori PCR positive biopsies, one was positive for cagA with vacA s2/ml strain type, 7 were positive for babA2 and histological examination revealed mild to moderate inflammation. H. pylori infection showed significant association with HLA-DQA1*0102 (p=0.044) and inflam m ation (p=0.030). HLA-DQA1*0103 and HLA-DQB1*0301 showed no significant association with either H. pylori infection, inflammation or file presence of virulence genes. Conclusion: HLA-DQA1*0102 allele has a significant association with H. pylori infection while HLA-DQA1*0103 and HLA-DQB1*0301 shows no significant association in a Sri Lankan dyspeptic patient population. Keywords - Dyspepsia, Human Leukocyte Antigen, HLA-DQ, Helicobacter pylori, virulence genes.