<i>Helicobacter pylori</i> Reinfection in Brazilian Patients with Peptic Ulcer Disease: A 5‐Year Follow‐Up

Silva, Fernando M.; Navarro–Rodriguez, Tomás; Mattar, Rejane; Hashimoto, Cláudio L.; Eisig, Jaime Natan

doi:10.1111/j.1523-5378.2009.00734.x

Cited by 20 publications

(15 citation statements)

References 37 publications

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“…An international analysis of reported re-infection rates estimated summary rates of 2.7% for developed countries (3,014 patients followed for 24–60 months) and 13% for developing countries (2,071 patients followed for 12–60 months) (16,17), but there is extensive variation within these groupings depending on the population studies. One study, for example, estimated the re-infection rate at 1.8% per year in a population of Brazilian patients with dyspeptic diseases (18). The AHPP is one of a very few sources of data on H. pylori incidence and re-infection rates in the circumpolar north.…”

Section: Discussionmentioning

confidence: 99%

Helicobacter pyloriincidence and re-infection in the AklavikH. pyloriProject

Carraher

Chang

Munday

et al. 2013

International Journal of Circumpolar Health

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BackgroundThe Aklavik H. pylori Project (AHPP) (www.canhelpworkinggroup.ca) is a community-driven project examining Helicobacter pylori infection and its influence on health in a diverse Aboriginal community in the Northwest Territories. Initial research revealed that 58% of 333 participants who underwent a urea breath test (UBT) between 2007 and 2010 were H. pylori-positive. From 2008 to 2010, we offered treatment to H. pylori-positive participants and 113 consented to this treatment.ObjectiveWe estimated H. pylori incidence in AHPP participants who initially tested negative and the re-infection frequency in initially positive participants who were successfully treated to clear the infection.MethodsParticipants who were initially H. pylori-negative or negative after treatment during 2008–2010 were eligible for inclusion. From November 2011 to June 2012, participants were offered a UBT and the samples were analyzed using infrared spectroscopy (IRIS). Participants with a positive test result were classified as new cases for estimating incidence among participants testing negative at baseline and re-infection among those successfully treated for H. pylori infection.ResultsAmong 38 initially negative participants, follow-up UBT showed that 33 remained negative, 3 were positive, and 2 had uncertain status. The estimated incidence proportion during the follow-up period was 8.3% (95% CI: 1.8–22.0%). Among 43 participants with a negative post-treatment UBT, 41 remained negative and 2 were positive. The estimated re-infection proportion during the follow-up period was 4.7% (95% CI: 0.6–16.0%). The frequency of new cases was similar in males and females. Aboriginal participants had a combined re-infection/incidence rate of 2.4% per year (95% CI: 0.8–5.9% per year). All 9 non-Aboriginal participants remained free from infection throughout the study period, as did all 23 participants aged 55 years and above.ConclusionsThe AHPP has substantially reduced the burden of infection in Aklavik since 2008. Continued monitoring, treatment, community engagement and knowledge translation activities are needed to ensure a lasting benefit of the project.

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Section: Discussionmentioning

confidence: 99%

Helicobacter pyloriincidence and re-infection in the AklavikH. pyloriProject

Carraher

Chang

Munday

et al. 2013

International Journal of Circumpolar Health

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“…For eradication control, ideally after three months of treatment, the breath test rapidly confirms the disappearance of H. pylori 31 , unlike the serological techniques, which need a prolonged period of time to confirm the eradication effect. Thus, because antibody titers can take up to six months to fall after successful treatment, serological tests cannot readily be used to assess the efficacy of H. pylori eradication regimens shortly after treatment 8 .…”

Section: Discussionmentioning

confidence: 99%

Validation of a rapid stool antigen test for diagnosis of Helicobacter pylori infection

Silva

Villares

Monteiro

et al. 2010

Rev. Inst. Med. trop. S. Paulo

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SUMMARYThe aim of this study was to validate the rapid lateral flow Helicobacter pylori stool antigen test (One step H. pylori antigen test, ACON laboratories, San Diego, USA; Prime diagnostics, São Paulo), using 13 C-Urea Breath Test as the gold standard for H. pylori infection diagnosis. A total of 98 consecutive patients, asymptomatic or dyspeptic, entered the study. Sixty-nine were women, with a mean age of 45.76 ± 14.59 years (14 to 79 years). In the H. pylori-positive group, the rapid stool antigen test detected H. pylori antigen in 44 of the 50 positive patients (sensitivity 88%; 95% CI: 75.7-95.5%), and six false-negative; and in the H. pylori-negative group 42 presented negative results (specificity 87.5%; 95% CI: 74.7-95.3%), and six false-positive, showing a substantial agreement (Kappa Index = 0.75; p < 0.0001; 95% CI: 0.6-0.9). Forty four of fifty patients that had positive stool antigen were H. pylori-positive, the PPV of the stool antigen test was 88% (95% CI: 75.7-95.5%), and 42 patients with negative stool antigen test were H. pylori-negative, the NPV of the stool antigen test was 87.5% (95% CI: 74.7-95.3%). We conclude that the lateral flow stool antigen test can be used as an alternative to breath test for H. pylori infection diagnosis especially in developing countries.

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“…In fact, many studies document persistence of H. pylori infection in the follow-up of patients even after appropriate treatment [11][12][13][14][15][16]. In our clinical team, the antibiotic protocol evolved according to successive guidelines, and remained based on a combination of amoxicillin+clarithromycin or metronidazole+omeprazole.…”

Section: Persistence Of H Pylori Infection After An Initial Positivementioning

confidence: 99%

Follow-up ofHelicobacter pyloriinfection in children over two decades (1988–2007): persistence, relapse and acquisition rates

et al. 2013

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Helicobacter pylori culture on gastric biopsy was performed on 4964 subjects aged <18 years from 1988 to 2007 at a central laboratory in Brussels. The total number of biopsies increased markedly from 941 in 1988-1993 to 1608 in 2004-2007. Biopsies were repeated at least once for 922 subjects (603 initially negative and 319 initially positive for H. pylori). Persistence rate of H. pylori at 1 year after initial positive biopsy was greater in the 1998-2007 cohort than in the 1988-1997 cohort (72.7% vs. 45.8%, P = 0.002), suggesting a tailored selection of candidates for biopsy with non-invasive tests (13C urea breath test). Of 68 subjects initially positive and re-examined subsequently after a documented cure, re-infection/relapse rate was 48.6% within 5 years post-elimination of H. pylori. Acquisition rate over 10 years follow-up in the initially negative cohort (603 patients) was 38.7% (re-infection/relapse vs. acquisition: P < 0.001). Multivariate analysis showed a fourfold greater risk of H. pylori acquisition in children of non-European origin vs. European origin (P < 0.001). Clarithromycin and metronidazole susceptibility were determined in 226 and 223 paired positive cultures in cases of re-infection/relapse or persistence. An initial non-susceptibility profile was highly predictive of a subsequent non-susceptibility profile, and the non-susceptible proportion increased markedly from 13.3% to 21.2% for clarithromycin (P < 0.001) and from 27.3% to 35.0% for metronidazole (P = 0.014), with no difference regarding European or non-European origin.

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Helicobacter pylori Reinfection in Brazilian Patients with Peptic Ulcer Disease: A 5‐Year Follow‐Up

Abstract: Brazil presents a low prevalence of H. pylori reinfection, similar to the developed countries.

Cited by 20 publications

References 37 publications

Helicobacter pyloriincidence and re-infection in the AklavikH. pyloriProject

Helicobacter pyloriincidence and re-infection in the AklavikH. pyloriProject

Validation of a rapid stool antigen test for diagnosis of Helicobacter pylori infection

Follow-up ofHelicobacter pyloriinfection in children over two decades (1988–2007): persistence, relapse and acquisition rates

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