title: Helicobacter pylori reinfection is virtually absent after successful eradication.
abstract: 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.
authors.affiliation: Department of Gastroenterology, Medical Microbiology, and Histopathology, Academic Medical Center, Amsterdam, Netherlands.
authors.forename: R W
authors.initials: RW
authors.lastname: van der Hulst
authors.forename: E A
authors.initials: EA
authors.lastname: Rauws
authors.forename: B
authors.initials: B
authors.lastname: Köycü
authors.forename: J J
authors.initials: JJ
authors.lastname: Keller
authors.forename: F J
authors.initials: FJ
authors.lastname: ten Kate
authors.forename: J
authors.initials: J
authors.lastname: Dankert
authors.forename: G N
authors.initials: GN
authors.lastname: Tytgat
authors.forename: A
authors.initials: A
authors.lastname: van der Ende
mesh_terms: 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
chemical_list: D000907:Antibodies, Bacterial; D004269:DNA, Bacterial; D014508:Urea