Age as risk factor for Helicobacter pylori recurrence in children in Vietnam.
BACKGROUND
The determinants for acquisition of Helicobacter pylori infection remain incompletely understood. The study aim was to investigate risk factors for recurrence in children in Vietnam during 1 year immediately following successful H. pylori eradication.


METHODS
In a prospective longitudinal study, 136 children, 3-15 years of age, were seen every 3 months for a total of four visits. Helicobacter pylori infection status was determined by an antigen-in-stool test (Premier Platinum HpSA PLUS) on samples obtained at each visit. A questionnaire was filled out at the start of the study.


RESULTS
After 1 year, 30 children had become H. pylori positive, while 17 were lost to follow-up. Low age was the most prominent independent risk factor for recurrence: adjusted hazard ratio (HR) among children aged 3-4, 5-6, and 7-8 years, relative to those aged 9-15 years, were, respectively, 14.3 [95% CI 3.8-53.7], 5.4 [1.8-16.3] and 2.6 [0.7-10.4]. Surprisingly, female sex tended to be associated with increased risk (adjusted HR among girls relative to boys 2.5 [95% CI 1.1-5.9]). No other factors such as sibship size, birth order, bed sharing, sanitary standards, or factual antibiotic dose per kilo bodyweight in the eradication trial were found to be significant risk factors for re-infection.


CONCLUSIONS
The main risk factor for recurrence with H. pylori was found to be age, with the youngest children running the greatest risk. The finding lends support to the observation that early childhood may be the main age of acquisition of H. pylori infection and for postponing attempts of eradication in high-prevalence areas unless motivated for medical reasons.
Unit of Clinical Microbiology, Department of Microbiology, Tumor- and Cell Biology (MTC), Karolinska Institutet and Clinical Microbiology, Karolinska University Hospital Solna, Stockholm, Sweden.
Thi Viet Ha
TV
Nguyen
Carina
C
Bengtsson
Gia Khanh
GK
Nguyen
Li
L
Yin
Thi Thu Ha
TT
Hoang
Dac Cam
DC
Phung
Mikael
M
Sörberg
Marta
M
Granström
D000293:Adolescent; D000367:Age Factors; D000942:Antigens, Bacterial / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005243:Feces / Q000382:microbiology; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014744:Vietnam / Q000453:epidemiology
D000942:Antigens, Bacterial