Helicobacter pylori eradication: are we really all equal? A controlled study in native and immigrant population.
Italy's shift to a tertiary economy has modified the working market, concentrating demand also on unqualified one, which includes most immigrants. It is also well established that low socio-economical conditions are associated with an increased prevalence of H. pylori infection. The aims of this study were to compare: (1) the efficacy of a 7 days triple therapy in immigrant and in Italian patients; (2) the prevalence of PUD between these two groups of patients. A total of 116 consecutive immigrant and 112 Italian H. pylori infected patients were recruited between 2007 and 2008. Patients underwent (13)C-UBT, endoscopy with biopsies, and were offered a 7-day triple therapy. Eradication rate (ER) was assessed 8 weeks after the end of the treatment using (13)C-UBT. The two populations differed for median age (p < 0.01), prevalence of PUD (p < 0.01), and smoking status (p < 0.01). The ER according to the ITT analysis was 70% for Italian and 48.3% for immigrant (p < 0.01). Multivariate analysis including country of origin, sex, age, PUD, smoking, and alcohol status found that immigrant had an adjusted OR for not eradicating of 2.14 (p = 0.03). In immigrant patients resident in Italy, performance of triple therapy was lower than expected. Further studies are demanded to confirm and clarify these intriguing results.
Gatta
Luigi
L
Gastroenterology and Endoscopy Unit, Versilia Hospital, Lido di Camaiore, Italy. gattaluigi@yahoo.it
Di Mario
Francesco
F
Vaira
Dino
D
Franzé
Angelo
A
Rugge
Massimo
M
Pilotto
Alberto
A
Lucarini
Paolo
P
Lera
Maurizio
M
Fiorini
Giulia
G
Castelli
Valentina
V
Kajo
Enkleda
E
Scarpignato
Carmelo
C
D000328:Adult; D004359:Drug Therapy, Combination; D054242:Emigrants and Immigrants; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000208:ethnology*; D016480:Helicobacter pylori / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000188:drug therapy* / Q000453:epidemiology / Q000235:genetics / Q000382:microbiology; D011446:Prospective Studies