Seroprevalence of hepatitis A virus and Helicobacter pylori infections in the general population of a developed European country (the San Marino study): evidence for similar pattern of spread.
OBJECTIVE
To evaluate the role of faecal-oral transmission in the spread 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 random sample of 1528 healthy subjects aged 20-85 years from the Republic of San Marino. Serum samples from each subject were then tested for anti-H. pylori and anti-hepatitis A antibodies.


RESULTS
Overall, 529 of 670 H. pylori-seropositive subjects (78.9%) and 460 of 858 H. pylori-seronegative subjects (53.6%) were hepatitis A seropositive (P<0.01; odds ratio=3.2; confidence interval 95%=2.6-4.1). This association remained after adjustment by a multiple logistic regression analysis for the confounding effect of age and length of schooling, as surrogate for socio-economic status (OR=2.0; CI 95%=1.3-3.3). The age-specific prevalence curves for H. pylori and hepatitis A infections showed a parallel increase by age, although to a lesser extent for H. pylori.


CONCLUSIONS
These findings provide evidence that in the community studied H. pylori may have spread in a manner similar to that of hepatitis A.
Pretolani
S
S
Istituto di Medicina Interna, Policlinico S. Orsola, Bologna, Italy.
Stroffolini
T
T
Rapicetta
M
M
Bonvicini
F
F
Baldini
L
L
Mègraud
F
F
Ghironzi
G C
GC
Sampogna
F
F
Villano
U
U
Cecchetti
F
F
Giulianelli
G
G
Stefanelli
M L
ML
Armuzzi
A
A
Miglio
F
F
Gasbarrini
G
G
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D004522:Educational Status; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000276:immunology / Q000635:transmission; D016480:Helicobacter pylori / Q000276:immunology; D006506:Hepatitis A / Q000453:epidemiology* / Q000276:immunology / Q000635:transmission; D006801:Humans; D008297:Male; D008875:Middle Aged; D012496:San Marino
D000907:Antibodies, Bacterial; D000914:Antibodies, Viral