Helicobacter pylori recurrence after successful eradication: 5-year follow-up in the United States.
OBJECTIVE
We previously reported a 3.4% posttreatment Helicobacter pylori recurrence rate over 18 months. We undertook to establish the rate of reinfection in our United States cohort up to 80 months after successful therapy.


METHODS
Previously studied patients who had successful triple therapy for H. pylori during 1989-92 were identified. Baseline infection had been established by the presence of H. pylori on antral biopsies as well as positive [13C]urea breath tests. Eradication of H. pylori had been confirmed by repeat endoscopy and breath test 4 wk after therapy. Three of four subjects reported that H. pylori recurrences had occurred in the first year after therapy. Patients remaining free of infection were invited back for follow-up breath test in 1995-1996.


RESULTS
One hundred fourteen patients were identified: 56 were unavailable or were using medications that would interfere with H. pylori testing. The remaining 58 patients (50.9%) included 32 M/26 F, mean age 62.9 yr. The mean follow-up period was 58 months, range 34-80 months. Positive breath tests occurred in 2/58 patients (3.4%) at 54 and 70 months after therapy. Both patients reported recurrent epigastric symptoms. The H. pylori recurrence rate for our group was 3.4% over the 4 yr since their last evaluation, or 0.85% recurrence per year. Defining recurrence as reinfection occurring after 1 yr, the total recurrence rate for the group over the 5 yr since treatment was 3/59 patients (5.1%), or 1.0% H. pylori recurrence per year posttreatment.


CONCLUSIONS
The rate of H. pylori reinfection after successful therapy is low in the United States and approximates 1% per year.
Abu-Mahfouz
M Z
MZ
Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan, USA.
Prasad
V M
VM
Santogade
P
P
Cutler
A F
AF
D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D001944:Breath Tests; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000188:drug therapy; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000175:diagnosis* / Q000188:drug therapy; D012008:Recurrence; D013997:Time Factors; D014481:United States; D014508:Urea / Q000032:analysis
D000897:Anti-Ulcer Agents; D000907:Antibodies, Bacterial; D014508:Urea