Comparison of biopsy and serological methods of diagnosis of Helicobacter pylori infection and the potential role of antibiotics.
OBJECTIVE
Endoscopic biopsy and serological methods were compared for their ability to detect Helicobacter pylori infection in patients undergoing upper gastrointestinal endoscopy at a state university hospital.


METHODS
Subjects were characterized on the basis of gastrointestinal symptoms, endoscopic findings, socioeconomic and demographic features, and the use of certain medications, tobacco, and alcohol. Current infection was detected in gastric antral specimens by rapid urease testing, histopathology, and bacterial culture. Serum levels of IgG to H. pylori were measured by ELISA.


RESULTS
Of 240 subjects, 115 (47.9%) were currently infected as determined by rapid urease testing, histopathology, and/or culture results, whereas 63.3% had elevated anti-H. pylori IgG levels (p < 0.001). This difference in the prevalence of current infection and seropositivity was preserved when the study population was analyzed according to age, race, gender, and other characteristics. Prior use of antibiotics was associated with a significant reduction in the frequency of H. pylori infection.


CONCLUSIONS
Serological evidence of H. pylori infection was consistently greater than the prevalence of infection documented by biopsy methods in this study, suggesting suppression or recent clearance of infection. Further studies are needed to examine the factors that may affect the detection of H. pylori infection.
Department of Internal Medicine, University of Texas Medical Branch, Galveston 77555-0764, USA.
G K
GK
Luthra
A R
AR
DiNuzzo
W K
WK
Gourley
S E
SE
Crowe
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000907:Antibodies, Bacterial / Q000097:blood*; D001706:Biopsy; D016145:Endoscopy, Digestive System; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology*; D016481:Helicobacter Infections / Q000175:diagnosis*; D016480:Helicobacter pylori / Q000201:enzymology / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011706:Pyloric Antrum; D014510:Urease / Q000032:analysis
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D014510:Urease