Helicobacter pylori reinfection is virtually absent after successful eradication.
This study examined whether reinfection or recrudescence accounts for the reappearance of Helicobacter pylori infection after apparent successful eradication. In a prospective study, 173 patients cured from H. pylori infection underwent follow-up endoscopies, with biopsies for culture and histopathology, every 3 months during the first year after treatment. Subsequently, elective half-yearly endoscopies were performed in 124 patients; the remaining 49 underwent follow-up endoscopy only in 1995. At reappearing infection, DNA profiles of pretreatment and recurrent strains were compared. After 3.5 years (range, 1.0-9.2), H. pylori infection recurred in 9 patients (5.2%). Reappearing infections were classified as endoscopically transmitted reinfection (n = 2), unclassified because of loss of pretreatment isolate (n = 1), or recrudescence (identical DNA patterns before and after treatment; n = 6). The reappearance rate of infection, discarding endoscopic transmission, was 1.2% (7/601 H. pylori-negative patient-years). There was virtually no reinfection with H. pylori after eradication in this adult Western population. These data do not rule out acquisition of H. pylori.
van der Hulst
R W
RW
Department of Gastroenterology, Medical Microbiology, and Histopathology, Academic Medical Center, Amsterdam, Netherlands.
Rauws
E A
EA
Köycü
B
B
Keller
J J
JJ
ten Kate
F J
FJ
Dankert
J
J
Tytgat
G N
GN
van der Ende
A
A
D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D001944:Breath Tests; D004269:DNA, Bacterial / Q000032:analysis; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000276:immunology*; D016480:Helicobacter pylori / Q000235:genetics / Q000276:immunology; D006801:Humans; D012008:Recurrence; D014508:Urea / Q000032:analysis
D000907:Antibodies, Bacterial; D004269:DNA, Bacterial; D014508:Urea