Faecal antigen tests in the confirmation of the effect of Helicobacter eradication therapy.
BACKGROUND
The frequent occurrence of Helicobacter pylori infection requires significant health care resources after eradication therapy. Therefore the non-invasive testing methods are required to alleviate the increased work-load of health care personnel and to allow an easy control of eradication therapy. Conventionally, the effect of eradication therapy has been confirmed with 13C-urea breath test 4-6 weeks after a completed eradication.


OBJECTIVE
To assess the applicability of Helicobacter pylori stool antigen tests as alternatives to the breath test in the control of the effect of eradication therapy.


METHODS
Fifty patients were diagnosed Helicobacter-positive by endoscopy and histology as well as by rapid urease test from mucosal specimen. Four weeks after an eradication therapy the patients were subjected to 13C-urea breath test as well as to faecal Helicobacter pylori antigen tests with mono- and polyclonal primary antibodies.


RESULTS
The monoclonal and polyclonal stool tests had 94% and 88% sensitivity, and 100% and 97% specificity, respectively, in the detection of Helicobacter pylori infection as compared to the 13C-urea breath test. The non-invasive test results were completely parallel in patients with various grades of mucosal atrophy or intestinal metaplasia.


CONCLUSIONS
Monoclonal faecal Helicobacter pylori antigen test is slightly superior to the polyclonal test regarding the sensitivity in the detection of stool Helicobacter antigens. Due to their sufficient sensitivity and specificity, and to their practicability and cost-effectiveness, they can be recommended for non-invasive testing of Helicobacter pylori infection as alternatives to the 13C-urea breath test.
Paimela
Hannu M
HM
Department of Surgery, Helsinki University Central Hospital, Jorvi Hospital, Espoo, Finland. hannu.paimela@pp.inet.fi
Oksala
Niku K
NK
Kääriäinen
Ilpo P
IP
Carlson
Petteri J
PJ
Kostiala
Anja A
AA
Sipponen
Pentti I
PI
D000907:Antibodies, Bacterial; D000911:Antibodies, Monoclonal; D000942:Antigens, Bacterial / Q000032:analysis*; D001944:Breath Tests; D002247:Carbon Isotopes; D005243:Feces / Q000382:microbiology*; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D005756:Gastritis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D016480:Helicobacter pylori / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity
D000907:Antibodies, Bacterial; D000911:Antibodies, Monoclonal; D000942:Antigens, Bacterial; D002247:Carbon Isotopes