Long-term follow-up and serological study after triple therapy of Helicobacter pylori-associated duodenal ulcer.
OBJECTIVE
The purpose of this study was to monitor the change of IgG antibodies to Helicobacter pylori during the course of a long-term follow-up after the eradication of H. pylori, as well as to evaluate the efficacy of triple therapy in preventing the recurrence of duodenal ulcer (DU).


METHODS
Twenty-three DU patients with positive H. pylori were studied; among those patients, 20 ulcers healed after initial treatment of triple therapy. Each patient received a follow-up endoscopy and biopsy examination every 3 months for 1 yr, or whenever the ulcer symptoms recurred. Serological tests for IgG antibodies were performed with a commercial ELISA.


RESULTS
Of the 20 patients with healed ulcers, one dropped out of this study; the recurrence rate of DU at 1 yr was 5% (1/19). There was no recurrence of ulcer in 17 H. pylori-negative patients and only one recurrence out of two H. pylori-positive patients. After the eradication of H. pylori, the seroconversion rates of IgG were 5%, 21%, 42%, 76%, and 94% at 0, 3, 6, 9, and 12 months, respectively. After 6 months, 95% (18/19) of the patients in which H. pylori was eradicated had at least a one-grade fall in IgG titers (p < 0.001). One patient had a relapse of H. pylori which was accompanied with re-elevating IgG titers.


CONCLUSIONS
We conclude that seroconversion, which usually occurs after 1 yr, indicates complete eradication of H. pylori. Furthermore, we suggest that the success of the eradication of H. pylori can be judged without endoscopic examination, 8 months after treatment by triple therapy, according to the fall of IgG titers or seroconversion. Re-elevating IgG titers may be a warning of the possibility of relapse or reinfection of H. pylori.
Wang
W M
WM
Department of Internal Medicine, Kaohsiung Medical College, Taiwan.
Chen
C Y
CY
Jan
C M
CM
Chen
L T
LT
Perng
D S
DS
Lin
S R
SR
Liu
C S
CS
D000897:Anti-Ulcer Agents / Q000008:administration & dosage; D000907:Antibodies, Bacterial / Q000032:analysis*; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D004797:Enzyme-Linked Immunosorbent Assay; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D008795:Metronidazole / Q000008:administration & dosage; D009942:Organometallic Compounds / Q000008:administration & dosage; D012008:Recurrence; D012698:Serologic Tests; D013752:Tetracycline / Q000008:administration & dosage
D000897:Anti-Ulcer Agents; D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D009942:Organometallic Compounds; D008795:Metronidazole; D013752:Tetracycline; C002791:bismuth tripotassium dicitrate