[13C]-urea breath test without prior fasting and without test meal is accurate for the detection of Helicobacter pylori infection in Chinese.
OBJECTIVE
Conventional [13C]-urea breath test ([13C]-UBT) requires prior fasting and a test meal, which theoretically improves the accuracy of the test. However, recent studies have suggested that prior fasting and test meal may not be essential. We aimed to determine the accuracy of a new [13C]-UBT protocol without fasting in Chinese.


METHODS
Dyspeptic patients referred for upper endoscopy were recruited. The gold standard for Helicobacter pylori infection was the combination of Campylobacter-like organism (CLO) test and histology. Group I (n = 213) patients underwent [13C]-UBT with prior fasting and with citrate acid test meal. Group II (n = 123) patients underwent [13C]-UBT without prior fasting but with test meal. Group III (n = 90) patients underwent [13C]-UBT without prior fasting and without test meal.


RESULTS
The highest accuracy for groups I, II and III was 96.7, 95.1 and 95.5% using a cut-off value of 5.0, 5.5 and 3.5, respectively. The sensitivities and specificities were 97.4 and 95.8% in group I, 93.3 and 96.8% in group II, and 96.5 and 93.9% in group III, respectively.


CONCLUSIONS
The [13C]-UBT protocols without prior fasting and either with or without test meal produce highly accurate and reliable results in the Chinese population.
Ng
Fook Hong
FH
Department of Medicine, Ruttonjee Hospital, Hong Kong.
Lai
Kam Chuen
KC
Wong
Benjamin Chun Yu
BC
Wong
Wai Man
WM
Wong
Siu Yin
SY
Chow
Kai Chiu
KC
Yuen
Siu Tsan
ST
Leung
Suet Yi
SY
Lam
Shiu Kum
SK
D000328:Adult; D000368:Aged; D001944:Breath Tests; D002247:Carbon Isotopes / Q000032:analysis*; D002681:China; D004435:Eating; D005215:Fasting; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014508:Urea / Q000032:analysis*
D002247:Carbon Isotopes; D014508:Urea