[Helicobacter pylori screening in a general practice].
OBJECTIVE
The significance of Helicobacter pylori (Hp) infection in asymptomatic persons is largely unknown. This prospective study was undertaken to evaluate the diagnostic and, if appropriate, therapeutic relevance of a noninvasive screening for Hp. In addition, the practicality and validity of a simple serological test on whole blood was elucidated.


METHODS
100 consecutive patients (29 males, 71 females, median age 46 [18-79] years) of a general medical practice, seen in November of 1997, were included. Three patients had to be subsequently excluded, because they had been treated for Hp infection. All patients were given a standard interview after which a serological whole-blood test (BM-Test Helicobacter pylori; Boehringer Mannheim) and a 13C-urea breath test were performed as noninvasive reference. Endoscopy of the upper gastrointestinal tract was offered if the serology and/or the breath test were gative.


RESULTS
The Hp prevalence was 40%, rising significantly with age. The rapid serology test, when related to the breath test, had a negative and positive predictive value of < 80%. 44 of the 47 patients with a positive serological or breath test agreed to endoscopy. Eleven of them had a clinically significant abnormality macroscopically or histologically: four of them were found to have an Hp infection.


CONCLUSIONS
Asymptomatic Hp-positive persons frequently have clinically abnormal findings in the upper gastrointestinal tract. These data point to the need for a large multi-centre study with cost-effect analysis to evaluate a noninvasive Hp screening test in nonsymptomatic persons as a public health measure. The 13C-urea breath test would be suitable as such a screening method.
Hollenz
M
M
Institut für Pathologie, Klinikum Bayreuth.
Stolte
M
M
Labenz
J
J
D000328:Adult; D000368:Aged; D001706:Biopsy / Q000706:statistics & numerical data; D001944:Breath Tests / Q000379:methods; D002908:Chronic Disease; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D005773:Gastroscopy / Q000706:statistics & numerical data; D005858:Germany; D016481:Helicobacter Infections / Q000175:diagnosis*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012698:Serologic Tests / Q000379:methods / Q000706:statistics & numerical data; D013270:Stomach / Q000473:pathology; D014508:Urea / Q000032:analysis
D014508:Urea