Helicobacter pylori transmission: evidence from a comparison with hepatitis A virus.
OBJECTIVE
To assess the possibility that faecal-oral contact might play a role in the transmission of Helicobacter pylori.


METHODS
A cross-sectional comparison of the patterns of hepatitis A and H. pylori seropositivity.


METHODS
At interview, blood samples and questionnaire data were collected from a group of 467 male volunteers, aged 18-65, from Stoke-on-Trent, UK. Serum samples from each subject were then analysed for anti-H. pylori and anti-hepatitis A antibodies.


RESULTS
Overall, 100 of 175 H. pylori seropositive subjects (57.1%) and 113 of 292 H. pylori seronegative subjects (38.7%) were hepatitis A seropositive (chi 2 = 15.0, P < 0.001). This difference was not statistically significant after adjustment for age group and father's occupation, as a surrogate for socioeconomic status in childhood (P = 0.15). The seroprevalence of hepatitis A increased with age at a rate of 2.3% per year, compared to only 1.0% per year for H. pylori (P = 0.015).


CONCLUSIONS
These data suggest that the case for faecal-oral transmission of H. pylori, in a manner similar to the spread of hepatitis A, is not proven and that other modes of transmission, for instance through oral-oral contact, should also be considered.
Webb
P M
PM
Imperial Cancer Research Fund, Cancer Epidemiology Unit, Radcliffe Infirmary, Oxford, UK.
Knight
T
T
Newell
D G
DG
Elder
J B
JB
Forman
D
D
D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D003430:Cross-Sectional Studies; D005243:Feces / Q000382:microbiology; D016481:Helicobacter Infections / Q000453:epidemiology / Q000276:immunology / Q000635:transmission*; D016480:Helicobacter pylori / Q000276:immunology; D006506:Hepatitis A / Q000453:epidemiology / Q000276:immunology / Q000635:transmission*; D035922:Hepatitis A Antibodies; D006508:Hepatitis Antibodies / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000382:microbiology; D012959:Socioeconomic Factors
D000907:Antibodies, Bacterial; D035922:Hepatitis A Antibodies; D006508:Hepatitis Antibodies