Background: H. pylori eradication usually involves treatment with three or four drugs for at least 7 days. Possible advantages of short treatment regimens are better patient compliance and tolerability, and less adverse effects. Recently two reports have shown a cure rate of > 90% using a 4‐day quadruple therapy.Aim:To confirm these data and to evaluate the efficacy and tolerability of 4‐day quadruple therapy in a single centre.Methods:Thirty‐eight consecutive patients with non‐ulcer dyspepsia or peptic ulcer disease, and proven H. pylori infection, received 4 days of quadruple therapy (bismuth, tetracycline, metronidazole, lansoprazole). At least 6 weeks after treatment, endoscopy was repeated with six biopsies of antrum and corpus for histology and culture.Results:The intention‐to‐treat cure rate was 34/38 (89.5%, 95% CI: 79.7–99.2%). In the per protocol analysis the cure rate was 34/37 (91.9%, 95% CI: 83.1–100%). Primary metronidazole resistance was observed in two patients; both were cured. Metronidazole resistance induction was observed in one patient in whom therapy failed. The treatment was generally well tolerated.Conclusion:Routine use of 4‐day quadruple anti‐H. pylori treatment is effective and well tolerated.
SUMMARY Sera from two blood donors, one of whom was implicated in a case of post-transfusion hepatitis B, were found to be positive for anti-HBc and negative for HBsAg by conventional radioimmunoassay and were retested for HBsAg after concentration (pepsin digestion and polyethylene glycol precipitation). The presence of occult HBsAg was confirmed in both. These observations have implications for blood transfusion, and wider studies of anti-HBc in blood donors are recommended before the introduction of routine screening for anti-HBc and exclusion of the positive donors from blood donation.
The results of a pilot study on the prevalence of anti-HBc in HBsAg negative volunteer blood donors are presented. Two techniques for anti-HBc determination were compared--radioimmunoassay (RIA) and indirect immunofluorescence (IF). In a panel of 56 sera with known HBV markers, RIA was found to be significantly more sensitive than IF, and both techniques were specific. Out of 2,000 HBsAg negative blood donor sera tested by RIA, 46 (2.3%) were found positive for anti-HBc. In 24/24 sera, the specificity of the anti-HBc was confirmed. Also 37/46 (80.4%) anti-HBc positives were found positive for anti-HBs, leaving 9/2,000 (0.4%) blood donors positive only for anti-HBc. It is concluded that it would be premature to advocate the introduction of anti-HBc as a routine screening test of blood donors.
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