title: Helicobacter pylori status and symptom assessment two years after eradication in pediatric patients from a high prevalence area.
abstract: OBJECTIVE
  To establish the rate of Helicobacter pylori reinfection in children from an H. pylori high prevalence area, possible clinical features predictive of reinfection and the usefulness of re-treatment.
  
  
  METHODS
  65 consecutive children attending the authors' department between 1998 and 2000 who had proven successful H. pylori eradication were enrolled; 52 took part. Patients and family members were invited to undergo C-urea breath testing and to complete a simple questionnaire regarding symptoms and socioeconomic status. Patients with H. pylori reinfection were offered treatment; eradication was assessed by C-urea breath test 8 weeks after completion of treatment.
  
  
  RESULTS
  Of 52 children, 15 (28.8%) were H. pylori positive. Variables predictive of reinfection were age at primary infection and presence of an infected sibling. Although reinfected children were more frequently symptomatic than non-reinfected patients, no specific symptom was associated with reinfection. Of the nine re-treated patients who returned 8 weeks after completing therapy, the bacterium was eradicated in five (56%).
  
  
  CONCLUSIONS
  The 12.8% per year reinfection rate in childhood at 2 years that we observed should prompt a re-evaluation of H. pylori status even after a successful eradication. Living in an H. pylori high prevalence area increases the annual risk of reinfection by approximately fourfold over the annual risk in H. pylori low prevalence areas.
authors.affiliation: Dipartimento di Biomedicina Età Evolutiva, University of Bari, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Magistà
authors.forename: Enzo
authors.initials: E
authors.lastname: Ierardi
authors.forename: Stefania
authors.initials: S
authors.lastname: Castellaneta
authors.forename: Vito Leonardo
authors.initials: VL
authors.lastname: Miniello
authors.forename: Elena
authors.initials: E
authors.lastname: Lionetti
authors.forename: Antonio
authors.initials: A
authors.lastname: Francavilla
authors.forename: Philippe
authors.initials: P
authors.lastname: Ros
authors.forename: Nicola
authors.initials: N
authors.lastname: Rigillo
authors.forename: Alfredo
authors.initials: A
authors.lastname: Di Leo
authors.forename: Ruggiero
authors.initials: R
authors.lastname: Francavilla
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001944:Breath Tests; D002648:Child; D002675:Child, Preschool; D017291:Clarithromycin / Q000627:therapeutic use; D018562:Disease Transmission, Infectious; D004359:Drug Therapy, Combination; D004415:Dyspepsia / Q000188:drug therapy / Q000382:microbiology; D005190:Family; D005260:Female; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D009853:Omeprazole / Q000627:therapeutic use; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D055502:Secondary Prevention; D012923:Social Class; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D000658:Amoxicillin; D017291:Clarithromycin; D009853:Omeprazole