title: The Prevalence of Helicobacter pylori Remains High in African American and Hispanic Veterans.
abstract: BACKGROUND
  Helicobacter pylori in the United States has been declining in the 1990s albeit less so among blacks and Hispanics. As the socioeconomic status of racial groups has evolved, it remains unclear whether the prevalence or the racial and ethnic disparities in the prevalence of H. pylori have changed.
  
  
  METHODS
  This is a cross-sectional study from a Veteran Affairs center among patients aged 40-80 years old who underwent a study esophagogastroduodenoscopy with gastric biopsies, which were cultured for H. pylori irrespective of findings on histopathology. Positive H. pylori was defined as positive culture or histopathology (stained organism combined with active gastritis). We calculated age-, race-, and birth cohort-specific H. pylori prevalence rates and examined predictors of H. pylori infection in logistic regression models.
  
  
  RESULTS
  We analyzed data on 1200 patients; most (92.8%) were men and non-Hispanic white (59.9%) or black (28.9%). H. pylori was positive in 347 (28.9%) and was highest among black males aged 50-59 (53.3%; 44.0-62.4%), followed by Hispanic males aged 60-69 (48.1%; 34.2-62.2%), and lowest in non-Hispanic white males aged 40-49 (8.2%; 2.7-20.5%). In multivariate analysis, age group 50-59 was significantly associated with H. pylori (adjusted odds ratio (OR), 2.32; 95% confidence interval (CI), 1.21-4.45) compared with those aged 40-49, and with black race (adjusted OR, 2.57; 95% CI, 1.83-3.60) and Hispanic ethnicity (adjusted OR, 3.01; 95% CI, 1.70-5.34) compared with non-Hispanic white. Irrespective of age group, patients born during 1960-1969 had a lower risk of H. pylori (adjusted OR, 0.45; 95% CI, 0.22-0.96) compared to those born in 1930-1939. Those with some college education were less likely to have H. pylori compared to those with no college education (adjusted OR 0.51; 95% CI, 0.37-0.69).
  
  
  CONCLUSIONS
  Among veterans, the prevalence of active H. pylori remains high (28.9%) with even higher rates in blacks and Hispanics with lower education levels.
authors.affiliation: Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.|Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Theresa
authors.initials: T
authors.lastname: Nguyen
authors.affiliation: Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.
authors.forename: David
authors.initials: D
authors.lastname: Ramsey
authors.affiliation: Section of Gastro enterology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.|Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: David
authors.initials: D
authors.lastname: Graham
authors.affiliation: Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Yasser
authors.initials: Y
authors.lastname: Shaib
authors.affiliation: Section of Gastro enterology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.|Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Seiji
authors.initials: S
authors.lastname: Shiota
authors.affiliation: Section of Gastro enterology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.|Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Velez
authors.affiliation: Section of Gastro enterology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.|Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Cole
authors.affiliation: Section of Gastro enterology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.|Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Bhupinderjit
authors.initials: B
authors.lastname: Anand
authors.affiliation: Section of Gastro enterology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.|Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Vela
authors.affiliation: Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.|Section of Gastro enterology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.|Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Hashem B
authors.initials: HB
authors.lastname: El-Serag
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000302:isolation & purification; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012923:Social Class; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*; D058014:Veterans Health / Q000706:statistics & numerical data*
keywords: Helicobacter pylori; age group; birth cohort; race; socioeconomic status