Reversal of atrophic body gastritis after H. pylori eradication at long-term follow-up.
BACKGROUND
The effect of Helicobacter pylori treatment on the potential reversal of atrophic body gastritis (ABG) is controversial. Body atrophy reversal was evaluated in a cohort of H. pylori-negative and treated H. pylori-positive ABG patients.


METHODS
Observational long-term follow-up cohort study including 300 ABG patients with at least one follow-up gastroscopy with three biopsies from the antrum and three from the body performed no earlier than 1 year after diagnosis was included. H. pylori was diagnosed by Giemsa-stain and serology. H. pylori-positive patients (n = 192) were treated with bismuth-based triple regimen.


RESULTS
After a mean follow-up of 5.2 years, body atrophy reversal was observed in 42/300 patients (14%). Body atrophy reversal occurred more frequently in patients treated for H. pylori than in H. pylori-negative ones (21.3% vs 0.9%, p < 0.00001) and was observed between 2 and 8 years after treatment in 52% of cases. Predictive factors for body atrophy reversal at Cox-regression analysis were mild atrophy (HR 2.14; 95% CI 1.12-4.1), moderate-severe inflammation (HR 5.3; 95% CI 1.64-17.3), and absence of intestinal metaplasia (HR 2.4; 95% CI 1.2-4.8).


CONCLUSIONS
Body atrophy reversal was observed in about 20% of ABG patients treated for H. pylori infection, and about 50% of reversals occurred during long-term follow-up.
Department of Digestive and Liver Disease, Sant'Andrea Hospital, II School of Medicine University Sapienza of Rome, Italy.
Lucy
L
Vannella
Edith
E
Lahner
Cesare
C
Bordi
Emanuela
E
Pilozzi
Emilio
E
Di Giulio
Vito D
VD
Corleto
John
J
Osborn
Gianfranco
G
Delle Fave
Bruno
B
Annibale
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000752:Anemia, Pernicious; D000906:Antibodies / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005755:Gastrins / Q000097:blood; D005757:Gastritis, Atrophic / Q000382:microbiology / Q000473:pathology* / Q000628:therapy*; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D007422:Intestines / Q000473:pathology*; D008297:Male; D008679:Metaplasia / Q000473:pathology; D008875:Middle Aged; D010295:Parietal Cells, Gastric / Q000276:immunology; D020116:Pepsinogen A / Q000097:blood; D016016:Proportional Hazards Models; D011706:Pyloric Antrum / Q000382:microbiology / Q000473:pathology*; D012044:Regression Analysis; D012189:Retrospective Studies; D055815:Young Adult
D000906:Antibodies; D005755:Gastrins; D020116:Pepsinogen A