Prevalence of serum antibodies to Helicobacter pylori and to CagA protein in liver transplant recipients.
OBJECTIVE
To study Helicobacter pylori seroepidemiology before and after orthotopic liver transplantation.


METHODS
Serum samples obtained from 118 liver transplant recipients before and after transplantation were examined for the presence of IgG antibodies to H. pylori whole cell extract and to the CagA protein of H. pylori.


RESULTS
Of 118 patients, 64 (54.2%) were H. pylori positive, and 36 (56.3%) of these had CagA antibodies. Of the 64 seropositive patients, 22 (34.4%) remained positive and 42 (65.6%) became negative for H. pylori antibodies a median of 39 months after transplantation. Patients who seroreverted showed a tendency to lower pretransplantation antibody levels and had received antibiotic therapy for at least 4 days. Seroreversion or antibody persistence was not affected by age, sex, CagA antibody status, CagA antibody titer, duration of antibiotic therapy, or immunosuppressive drugs administered after liver transplantation.


CONCLUSIONS
The prevalence of H. pylori infection, as detected by serological screening, in patients selected for liver transplantation is not different from that in the general population. In these patients, the seroprevalence of H. pylori drops after liver transplantation. This is largely due to the intake of antibiotics and immunosuppressants by transplant recipients. Seroreversion seems to be independent of the type of H. pylori bacteria.
Rudi
J
J
Department of Medicine, University of Heidelberg, Germany.
Engler
S
S
Theilmann
L
L
Otto
G
G
Stremmel
W
W
D000328:Adult; D000367:Age Factors; D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood*; D000942:Antigens, Bacterial / Q000276:immunology*; D001379:Azathioprine / Q000008:administration & dosage / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000276:immunology*; D002511:Cephalosporins / Q000627:therapeutic use; D016009:Chi-Square Distribution; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D016481:Helicobacter Infections / Q000276:immunology*; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D007124:Immunoenzyme Techniques; D007074:Immunoglobulin G / Q000097:blood; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D016031:Liver Transplantation / Q000276:immunology*; D008297:Male; D010406:Penicillins / Q000627:therapeutic use; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D015995:Prevalence; D016036:Seroepidemiologic Studies; D012737:Sex Factors; D016559:Tacrolimus / Q000008:administration & dosage / Q000627:therapeutic use; D013997:Time Factors
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D002511:Cephalosporins; D005938:Glucocorticoids; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D010406:Penicillins; C080866:cagA protein, Helicobacter pylori; D016572:Cyclosporine; D001379:Azathioprine; D011241:Prednisone; D016559:Tacrolimus