title: Comparison of a monoclonal antigen stool test (Hp StAR) with the 13C-urea breath test in monitoring Helicobacter pylori eradication therapy.
abstract: OBJECTIVE
  To evaluate the agreement between a mAb-based stool test (HP StAR) and the urea breath test (UBT) in monitoring (H pylori) infection after eradication therapy.
  
  
  METHODS
  Patients with discordant results on UBT and Hp StAR underwent endoscopy with biopsies for rapid urease test, culture, and histology to confirm H pylori status.
  
  
  RESULTS
  Among 250 patients (50+/-14 years), 240 (96.0%) had concordant UBT and Hp StAR tests with a significant correlation between DOB and A values (R = 0.87; P<0.0001). The remaining 10 (4.0%) patients had discordant tests (positive Hp StAR and negative UBT) with the Hp StAR inaccurate in five cases (false positive) and UBT inaccurate in the other five cases (false negative). The "maximal expected" sensitivity, specificity, +PV, -PV, +LR, and -LR were 91%, 100%, 100%, 97.4%, infinity, and 8.2 respectively, for the UBT, and 100%, 97.4%, 91%, 100%, 38.8, and 0, respectively, for the Hp StAR. Overall accuracy for both tests was 98%.
  
  
  CONCLUSIONS
  Both the UBT and the Hp StAR are equally accurate in monitoring H pylori infection. Nowadays, the choice of the "best" non-invasive H pylori test in the post-treatment setting should be done not only in terms of diagnostic accuracy but also in view of cost and local facilities.
authors.affiliation: Department of Internal Medicine, Casa Sollievo della Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy. f.perri@operapadrepio.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Perri
authors.forename: Michele
authors.initials: M
authors.lastname: Quitadamo
authors.forename: Rosalba
authors.initials: R
authors.lastname: Ricciardi
authors.forename: Ada
authors.initials: A
authors.lastname: Piepoli
authors.forename: Rosa
authors.initials: R
authors.lastname: Cotugno
authors.forename: Annamaria
authors.initials: A
authors.lastname: Gentile
authors.forename: Alberto
authors.initials: A
authors.lastname: Pilotto
authors.forename: Angelo
authors.initials: A
authors.lastname: Andriulli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000276:immunology*; D000942:Antigens, Bacterial / Q000276:immunology*; D001944:Breath Tests; D005243:Feces / Q000737:chemistry*; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000517:prevention & control; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D007159:Immunologic Tests / Q000191:economics / Q000379:methods* / Q000592:standards; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D012680:Sensitivity and Specificity; D014508:Urea / Q000032:analysis*; D014510:Urease / Q000378:metabolism
chemical_list: D000911:Antibodies, Monoclonal; D000942:Antigens, Bacterial; D014508:Urea; D014510:Urease