Trends in the seroprevalence of Helicobacter pylori infection and its putative eradication rate over 18 years in Korea: A cross-sectional nationwide multicenter study

Abstract

The aims of this study were to demonstrate the trends in seropositivity and the eradication therapy rate for Helicobacter pylori (H. pylori) over an 18-year period in an asymptomatic Korean population and to explore the factors associated with H. pylori seropositivity and its eradication therapy. In total, 23,770 subjects (aged 17–97 years) from a health examination center participated in this cross-sectional study from January 2016 to June 2017. Questionnaires that included questions about the participants’ H. pylori eradication therapy history were collected, and anti-H. pylori IgG antibodies were measured. Among the eligible subjects, the seroprevalence of H. pylori infection was 41.5%. The H. pylori eradication therapy rate increased continuously from 2005 (13.9%) to 2011 (19.3%) and then increased again until the first half of 2017 (23.5%) (P < 0.001). After exclusion of subjects with a history of gastric surgery, gastric cancer, H. pylori eradication therapy, or gastric symptoms, H. pylori seropositivity was 43.9% in 16,885 subjects, which was significantly lower than the seropositivities in 1998 (66.9%), 2005 (59.6%), and 2011 (54.4%). The risk factors associated with H. pylori seropositivity according to multivariable analysis were male sex (odds ratio (OR) 1.34, 95% confidence interval (CI): 1.23–1.46), medium educational level (OR 1.17, 95% CI: 1.05–1.31), medium household income level (OR 1.10, 95% CI: 1.03–1.19), and age of 60–69 years (OR 8.78, 95% CI: 6.41–11.85). The observed downward trend in H. pylori seroprevalence and increase in H. pylori eradication over the 18-year period will affect upper gastrointestinal disorders in South Korea.

Review: Epidemiology of Helicobacter pylori infection

“…The most recent seroprevalence (41.5%) was substantially lower than that reported in previous studies, that is, 54.4% in 2011, 59.6% in 2005, and 66.9% in 1998 (trend P < .001) 8. The most recent seroprevalence (41.5%) was substantially lower than that reported in previous studies, that is, 54.4% in 2011, 59.6% in 2005, and 66.9% in 1998 (trend P < .001) 8.…”

“…The most recent seroprevalence (41.5%) was substantially lower than that reported in previous studies, that is, 54.4% in 2011, 59.6% in 2005, and 66.9% in 1998 (trend P < .001). 8 Another smaller study of similar design found 51.3% prevalence in 2016-2017, compared to 59.8% in 2011 (P < .001). 9 In China, H pylori prevalence among symptomatic children was analyzed between 2005 and 2017.…”

“…African origin participants had a higher prevalence (81.8%) when compared to Asian (46.7%) and Arab participants (30.7%, P < .0001). 8 Altogether 24 471 adult subjects, aged 16 years or older (mean age 51.7 years), having visited a healthcare center or an outpatient medical clinic for a routine health examination during the study period, were enrolled and investigated by means of upper endoscopy and serology (anti-H pylori IgG); data on behavioral factors and previous medical history were collected by using a questionnaire. In Korea, the trends in seroprevalence of H pylori among asymptomatic subjects within an 18-year period (1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017), the risk factors for the infection, and the frequency of eradication therapy were addressed in a cross-sectional nationwide multicenter study.…”

“…In Korea, the trends in seroprevalence of H pylori among asymptomatic subjects within an 18-year period (1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017), the risk factors for the infection, and the frequency of eradication therapy were addressed in a cross-sectional nationwide multicenter study. 8 Altogether 24 471 adult subjects, aged 16 years or older (mean age 51.7 years), having visited a healthcare center or an outpatient medical clinic for a routine health examination during the study period, were enrolled and investigated by means of upper endoscopy and serology (anti-H pylori IgG); data on behavioral factors and previous medical history were collected by using a questionnaire. The overall seroprevalence was 41.5%, increasing with age.…”

The prevalence of histologic atrophy and intestinal metaplasia in the corpus has decreased over 15 years in females in the Korean population

“…This result means that environmental factors, such as diet or smoking, also affect atrophy/IM. In Korea, the prevalence of H pylori continuously decreased to 43.9% at the age ≥16 years in 2016‐2017 from 1998 (66.9%), 2005 (59.6%), and 2011 (54.4%), and this decrease was due to improvements in the socioeconomic development of Korea; thus, there is a possibility that other factors of H pylori infection can affect the atrophy/IM pattern. A Japanese report showed a progressive and rapid decline in the prevalence of H pylori infection as well as a decrease in the rate of progression of gastric atrophy among the H pylori ‐infected Japanese population that was coincident with the westernization and improvements in economic and hygienic conditions since World War II .…”