A study from Indonesia presented at ACG 2025 found that virulent Helicobacter pylori genotypes (e.g., specific CagA, sabA, homA/B, iceA, babB variants) are linked to greater gastric microbial diversity and distinct bacterial communities, despite no overall α-diversity differences. These virulent strains were associated with co-colonization by additional taxa, including Veillonella (notably with East Asian–type CagA) and Klebsiella (in babB-negative samples). β-diversity analyses confirmed that microbial composition varied by pathogenic subtype, while diversity declined with gastric atrophy despite stable H. pylori dominance. The findings suggest that specific H. pylori virulence factors shape gastric microbiota structure, potentially influencing disease pathways.