Background: Helicobacter pylori (H. pylori) is a Gram-negative bacterium that colonizes the gastric mucosa. In Egypt, the Nile Delta has recorded an infection prevalence of around 70%. Chronic infection with H. pylori can progress to serious gastric diseases, including gastric cancer. However, the prevalence and assessment of gastric mucosa diseases, as well as H. pylori infection eradication through non-invasive measures such as serum pepsinogen (PG) screening, remain underexplored in Egypt.

Study Aim: The primary objective of this study was to determine the relation between H. pylori infection and serum pepsinogen levels among the adult Egyptian population to enable clinician for early detection of gastric mucosa diseases, H. pylori eradication, and intervention implementation through endoscopy surveillance for better targeted treatment.

Methods: The study recruited 100 participants from the Alexandria Main University Hospital. These participants were classified into three groups based on their H. pylori status, determined through the UBT and their presenting symptoms: Group I (symptomatic with H. pylori), Group II (asymptomatic with H. pylori), and Group III (healthy controls). After obtaining their signed informed consents, all participants underwent a comprehensive medical history assessment and a thorough clinical examination. We further investigated the serum levels of Pepsinogen I (PGI) and Pepsinogen II (PGII), as well as the PGI/PGII ratio. These parameters were analyzed for their correlation with H. pylori infection status, and intragastric H. pylori bacterial load (UBT values)