The long-term reinfection rate and the course of duodenal ulcer disease after eradication of Helicobacter pylori in a developing country

Abstract

OBJECTIVE:The aim of this study was to evaluate the effect of Helicobacter pylori (H. pylori) eradication on the natural history of duodenal ulcer disease and the reinfection rate after treatment in a developing country. METHODS:A total of 111 H. pylori-infected patients with duodenal ulcer were treated with either omeprazole or famotidine plus two antibiotics for 2 wk. Those failed to respond to treatment were retreated with bismuth-based triple therapy. RESULTS:The radication rate was 76% (95% CI: 67-83%). Eventually, H. pylori was eradicated in 96 of the 111 patients (86%), who were followed-up clinically and endoscopically for a mean of 37.2 months. The cumulative reinfection rate after eradication (Kaplan-Meier) was 8% Ϯ 3% in yr 1, 11% Ϯ 4% in yr 2, and 13% Ϯ 4% in yr 3. Nine of the 12 reinfections occurred during yr 1. Recurrence of duodenal ulcer was detected in five patients (5.2%), all of them during yr 1 of follow-up. Histologically, gastritis scores (according to the Sydney system) improved significantly after eradication. CONCLUSIONS:In a high prevalence setting, H. pylori eradication and early reinfection rates after treatment are similar to rates observed in a low prevalence environment, whereas the late reinfection rate seems to be higher. However, up to 3 yr after treatment, most treated patients are free of H. pylori infection and/or ulcer activity. Even longer follow-up studies are necessary to determine whether specific retreatment policies are necessary to maintain long term eradication in developing countries. (Am J Gastroenterol 2000;95: 50 -56.

Long-term recurrence rate after treatment of Helicobacter pylori infection in children and adolescents in Estonia

“…Higher recurrence rates within the first 12 months after treatment have been observed in some studies (43)(44)(45), but were not found in our study. It is suggested that the higher recurrence rates noted during the first post-treatment year are actually due to recrudescence of partially suppressed infection but not real reinfection (21,44,46).…”

Effect of Helicobacter pylori Infection on Ghrelin Expression in Human Gastric Mucosa

“…change in gastric mucosa with or without H. pylori infection (18). Second, a number of studies have shown that gastric glandular atrophy is unlikely to recover even after a year following successful H. pylori eradication, whether evaluated endoscopically or histologically (19,20). In spite of this lack of recovery in atrophy of the gastric mucosa, we saw increased ghrelin immunoreactivity 3 months after H. pylori eradication.…”

Helicobacter pyloriIs Not Eradicated after Triple Therapy: A Nested PCR Based Study

“…In an animal model, Cellini et al (1994) demonstrated that up to 3 months after inoculation viable but not culturable forms of H. pylori could still be detected in the mouse stomach [28]. A few studies [29, 30] were carried out to evaluate triple therapy comparing PCR with culture. However no report has included nested PCR.…”