Transient and persistent Helicobacter pylori colonization in Native American children.
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.
Pérez-Pérez
Guillermo I
GI
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
Sack
R Bradley
RB
Reid
Raymond
R
Santosham
Mathuram
M
Croll
Janne
J
Blaser
Martin J
MJ
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
D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; C080866:cagA protein, Helicobacter pylori; D020116:Pepsinogen A