Detection of Helicobacter pylori Antibodies in a Pediatric Population: Comparison of Three Commercially Available Serological Tests and One In-House Enzyme Immunoassay

Abstract

A serum immunoglobulin G enzyme immunoassay (EIA) forHelicobacter pylori antibodies already in use in adults was evaluated with 99 pediatric serum samples to determine its usefulness for the study of H. pylori disease in children. The reference method used was either the 13C-urea breath test or a biopsy culture of gastric mucosa. In children, an EIA cutoff of 0.35 absorbancy unit yielded sensitivity, specificity, and positive and negative predictive values of 93, 97, 93, and 97%, respectively. The cutoff recommended when this EIA was published for use in adults was 0.70 absorbancy unit (H. Gnarpe, P. Unge, C. Blomqvist, and S. Mäkitalo, APMIS 96:128–132, 1988). Another subset of 169 serum samples taken from children was analyzed by four serological tests in order to compare the performance of the in-house EIA with the Pyloriset, HM-CAP, and Helico-G kits. For the 169 samples, 10 (5.9%) false-positives and no false-negatives occurred with the Helico-G, 3 (1.8%) false-positives and no false-negatives occurred with the Pyloriset, and 3 (1.8%) false-positives and 1 (0.6%) false-negative occurred with the HM-CAP. For the 169 samples, 1 (0.6%) false-positive and no false-negatives occurred with the in-house EIA. Serological detection of H. pylori antibodies with our EIA seems to be valuable in diagnosing H. pylori infection in children, but only if a lowered, specific pediatric cutoff is established. The commercial kits, particularly the Helico-G, seem to overdiagnose pediatric H. pylori infection. A positive serological test for H. pylori infection, particularly for children, needs to be confirmed by a reference method because of the possibility of spontaneous eradication of infection, with a lingering serological response.

Thin layer immunoassay; an economical approach to diagnoseHelicobacter pyloriInfection in gastroduodenal ulcer disease patients of Pakistan; a comparative analysis

“…pylori closely related species [22]. In our study, we not found false-positive result; hence, no absorption step was considered necessary.…”

“…Whole cell lysate is the best choice of antigen as compared to a purified antigen which unable to recognize various type of antibodies present in the population. A different population may harbor different natures of H. pylori antigen [22]. H. pylori local strain antigen is useful with enough influence on the diagnostic properties of serological assay [18].…”

Serum Pepsinogen Values in Japanese Junior High School Students With Reference to <i>Helicobacter Pylori</i> Infection

“…Third, the students were evaluated using only urine and serum tests to identify whether a subject is H. pylori infected. Some reports have suggested that the antibody test is inaccurate for the diagnosis of H. pylori infection in children, 29,30 but the both serum and urine antibody kits showed a good diagnostic accuracy. [17][18][19] On the other hand, a strength of the present study is that both urine and serum antibody tests were performed for H. pylori infection diagnosis.…”

Comparative Evaluation of 29 Commercial Helicobacter pylori Serological Kits

“…The performances of several kits have been evaluated in several articles [22][23][24][25]. Three meta-analyses performed on a general or pediatric population have been published [26][27][28].…”