title: Transient and persistent Helicobacter pylori colonization in Native American children.
abstract: Helicobacter pylori is chiefly acquired in childhood, but the exact timing of acquisition is not well understood. The main goal of this study was to assess H. pylori acquisition in a pediatric population. We studied two cohorts of Native American children: a birth cohort of 50 children and 58 older children (mean age, 53 months). We measured serum immunoglobulin G (IgG), IgM, and IgA antibodies to H. pylori whole-cell antigen and IgG antibodies to CagA. Among 44 birth cohort children monitored for more than 12 months, 24 (54.5%) had seroconversions, 7 (15.9%) were transient, and 17 (38.6%) were persistent. Among the older children, 49 (84.5%) of the 58 children were monitored for 1 year; 34 (69.4%) had H. pylori antibodies at study entry. During the next year, 7 (20.6%) children seroreverted, and of 15 initially negative children, 5 (33.3%) seroconverted. In both groups, evaluation of CagA antibodies increased the sensitivity of H. pylori detection. Serum pepsinogen I (PGI) levels in H. pylori-negative children rose significantly until age 6 months and remained constant for the next 19 months. At the time of H. pylori seroconversion, PGI peaked to levels significantly higher than in the never-seroconverted (P = 0.02) and the pre-seroconverted (P = 0.03) children, but then declined to levels paralleling those of H. pylori-negative children. Thus, H. pylori acquisition, accompanied by a transient PGI increase, was frequent in this population, especially in the second and third years of life, but often was brief.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, New York University School of Medicine, New York, New York 10016, USA. guillermo.perez-perez@med.nyu.edu
authors.forename: Guillermo I
authors.initials: GI
authors.lastname: Pérez-Pérez
authors.forename: R Bradley
authors.initials: RB
authors.lastname: Sack
authors.forename: Raymond
authors.initials: R
authors.lastname: Reid
authors.forename: Mathuram
authors.initials: M
authors.lastname: Santosham
authors.forename: Janne
authors.initials: J
authors.lastname: Croll
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Blaser
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D000942:Antigens, Bacterial / Q000276:immunology; D001426:Bacterial Proteins / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D007198:Indians, North American; D007223:Infant; D020116:Pepsinogen A / Q000097:blood
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; C080866:cagA protein, Helicobacter pylori; D020116:Pepsinogen A