Long-term follow-up Helicobacter pylori reinfection rate and its associated factors in Korea.
BACKGROUND
The reinfection rate of Helicobacter pylori has been reported to be low in developed countries but high in developing countries. The aim of this study is to evaluate the long-term reinfection rate of H. pylori and to investigate its associated risk factors in South Korea.


METHODS
During 2003-2010, H. pylori-positive 970 patients received standard proton pump inhibitor (PPI)-based triple eradication therapy, and follow-up H. pylori tests were performed with (13) C urea breath test or invasive tests (Giemsa histology, CLO test, and culture) 4 weeks after completion of treatment. A total of 331 patients who were maintained an H. pylori-eradicated state at 1 year after eradication were divided into two groups according to reinfection. For the evaluation of risk factors of reinfection, gender, age, smoking, alcohol, income, education, gastrointestinal symptoms, clinical diagnosis, histologic atrophic gastritis or intestinal metaplasia, and clarithromycin resistance were analyzed.


RESULTS
The follow-up period was 18-95 months (mean: 37.1 months), and H. pylori reappeared in 36 of 331 patients (10.9%), resulting in the annual reinfection rate of 3.51% per year. Multivariate analysis showed that male gender (HR 2.28; 95% CI, 1.05-5.00, p = .037) and low monthly family income (≤5000$ vs >5000$) (HR 3.54; 95% CI, 1.08-11.67, p = .038) were associated with H. pylori reinfection.


CONCLUSIONS
This long-term reinfection rate of H. pylori stayed rather low (3.51% per year), and male and low income determined the reinfection, factors already known to be important for H. pylori infection.
Department of Internal medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea.
Min Soo
MS
Kim
Nayoung
N
Kim
Sung Eun
SE
Kim
Hyun Jin
HJ
Jo
Cheol Min
CM
Shin
Sang Hyub
SH
Lee
Young Soo
YS
Park
Jin-Hyeok
JH
Hwang
Jin-Wook
JW
Kim
Sook-Hyang
SH
Jeong
Dong Ho
DH
Lee
Jung Mogg
JM
Kim
Hyun Chae
HC
Jung
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001944:Breath Tests; D017291:Clarithromycin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005757:Gastritis, Atrophic / Q000453:epidemiology; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012008:Recurrence; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult
D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D017291:Clarithromycin