Seroepidemiology of Helicobacter pylori Infection in Heart Transplant Recipients

Abstract

We analyzed serum samples obtained from 100 heart transplant recipients before and after transplantation for the presence of IgG antibodies to Helicobacter pylori. Enzyme-linked immunosorbent assay revealed that 35 patients were seropositive before the procedure. Seropositive patients were older than seronegative patients, but the two groups did not differ in terms of cardiac diagnosis, gender, survival, or the number of admissions or rejection episodes. In addition, seropositive patients did not have more-frequent episodes of gastritis, ulcer disease, or gastrointestinal bleeding. Over a mean serological follow-up of 3.4 years, only one of 65 seronegative patients seroconverted. Of the 35 seropositive patients, 14 became seronegative for H. pylori a median of 194 days (range, 47-2,657 days) after transplantation. Seroreverters, as compared with serofast patients, had received more intravenous and total antibiotics during follow-up (P = .01), were more likely to have received a combination of antibiotics active against H. pylori (P < .025), and had received more antirejection treatment (P = .01). The incidence of H. pylori infection is not increased after heart transplantation, and many seropositive patients serorevert after transplantation when antibacterial and immunosuppressive agents are administered.

Helicobacter pylori in solid-organ transplant recipient

“…The previously reported prevalence in renal [3 ,4-12], liver [13][14][15], and heart [16,17] transplant recipients is summarized in Tables 1 and 2. The prevalence of H. pylori infection in organ transplant recipients varies between reports, with 29-70% incidence reported in renal transplant recipients ( Table 1).…”

“…[12] [17] an earlier age in developing countries compared with industrialized nations [18]. Indeed, the prevalence also varies among control groups as shown in Table 1.…”

“…In all studies shown in Table 2, the prevalence of H. pylori-positive patients clearly decreased after transplantation. Spontaneous reversion to seronegativity for H. pylori has been reported in liver [13,15], heart [17], and renal [19] transplant recipients. In two reports [13,19], eradication of H. pylori after transplantation was confirmed by the other diagnostic tests for H. pylori such as urea breath test, stool antigen test, histology, or urease test in most patients who showed seroreversion, indicating that the seronegativity was not false-negative due to immunosuppressive condition.…”