New approaches to helicobacter pylori infection in children

Abstract

Helicobacter pylori infection is usually acquired during childhood, and evidence-based guidelines regarding diagnosis and treatment of infected children have been recently published. Diseases associated with H. pylori infection are gastritis, duodenal ulcers, mucosal-associated lymphoid-type (MALT) lymphoma, and gastric adenocarcinoma. The association of specific symptoms with H. pylori infection in children and adults (ie, recurrent abdominal pain and nonulcer dyspepsia) remains controversial. Additionally, the role of H. pylori in gastroesophageal reflux disease or in extra-gastrointestinal diseases (ie, coronary artery disease) lacks sufficient evidence to demonstrate causality. The diagnosis of H. pylori-associated diseases in children can reliably be made through gastroduodenal endoscopy with biopsies. Clinical trials are underway for the validation of noninvasive diagnostic tests for the H. pylori-infected child, and current guidelines recommend eradication therapy for infected children with duodenal and gastric ulcer, gastric lymphoma, and atrophic gastritis with intestinal metaplasia. The natural history of childhood H. pylori infection is poorly described. Moreover, rational approaches to the prevention and control of childhood H. pylori infection are critically needed, requiring characterization of the determinants for acquisition and persistence and the disease outcomes following eradication.

Prevalence and Risk Factors of Atrophic Gastritis and Intestinal Metaplasia: A Nationwide Multicenter Prospective Study in Korea

“…In addition, the prevalence of AG and IM in males were significantly higher than those in females. It is generally understood that the prevalence of H. pylori infection and gastric disorders in males is more common than that in females 16,17. Furthermore, seropositivity of H. pylori was found to be the risk factor of AG and IM in the present study.…”

“…H. pylori infection usually occurs in the childhood, but AG and IM progress in the elderly population due to long infectious periods with H. pylori 17. In addition, the prevalence of AG and IM in males were significantly higher than those in females.…”

Helicobacter pylori infection in children

“…[4041] Hence, the possible routes are feco–oral, oral–oral and gastro–oral. [42] Thomas et al were able to isolate H. pylori DNA and culture H. pylori from human feces, suggesting a feco–oral transmission. [43] Oral–oral transmission has also been recognized because H. pylori was isolated from dental plaques and saliva.…”

Helicobacter pylori infection: Detection, investigation, and management

“…18 Evidence also supports child-to-child transmission among those in crowded school or living conditions as well as in chronic care facilities for multiple handicapped children. 1 In contrast, transmission among adults is rareadults have a H pylori seroconversion rate of approximately 0.3% per person-year. Studies of families have found that one spouse may be positive, whereas the other remains negative, and that an uninfected parent remains negative even if children in the household are infected.…”

“…1 Infection with H pylori has also been linked pathologically to the development of gastric cancer. Worldwide, infection with H pylori is highly prevalent-approximately 50% of the world population is infected, with prevalence rates in countries ranging from 20% to more than 80%.…”