title: The diagnosis and treatment of Helicobacter pylori infection in Arctic regions with a high prevalence of infection: Expert Commentary.
abstract: Helicobacter pylori infection is a major cause of peptic ulcer and is also associated with chronic gastritis, mucosa-associated lymphoid tissue (MALT) lymphoma, and adenocarcinoma of the stomach. Guidelines have been developed in the United States and Europe (areas with low prevalence) for the diagnosis and management of this infection, including the recommendation to 'test and treat' those with dyspepsia. A group of international experts performed a targeted literature review and formulated an expert opinion for evidenced-based benefits and harms for screening and treatment of H. pylori in high-prevalence countries. They concluded that in Arctic countries where H. pylori prevalence exceeds 60%, treatment of persons with H. pylori infection should be limited only to instances where there is strong evidence of direct benefit in reduction of morbidity and mortality, associated peptic ulcer disease and MALT lymphoma and that the test-and-treat strategy may not be beneficial for those with dyspepsia.
authors.affiliation: Departments of Internal Medicine and Surgery,Alaska Native Tribal Health Consortium,Anchorage,AK,USA.
authors.forename: B J
authors.initials: BJ
authors.lastname: McMahon
authors.affiliation: Arctic Investigations Program,Division of Preparedness and Emerging Infections,National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention,Anchorage,AK,USA.
authors.forename: M G
authors.initials: MG
authors.lastname: Bruce
authors.affiliation: Department of Epidemiology Research,Statens Serum Institute,Copenhagen,Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Koch
authors.affiliation: Canadian North Helicobacter pylori Working Group,University of Alberta,Edmonton,Alberta,Canada.
authors.forename: K J
authors.initials: KJ
authors.lastname: Goodman
authors.affiliation: Department of State Medical Research Institute for Northern Problems,Siberian Division of Russian Academy of Medical Sciences,Krasnoyarsk,Russia.
authors.forename: V
authors.initials: V
authors.lastname: Tsukanov
authors.affiliation: Primary Health Care Clinic,Nuuk,Greenland.
authors.forename: G
authors.initials: G
authors.lastname: Mulvad
authors.affiliation: Department of Epidemiology Research,Statens Serum Institute,Copenhagen,Denmark.
authors.forename: M L
authors.initials: ML
authors.lastname: Borresen
authors.affiliation: Departments of Internal Medicine and Surgery,Alaska Native Tribal Health Consortium,Anchorage,AK,USA.
authors.forename: F
authors.initials: F
authors.lastname: Sacco
authors.affiliation: Departments of Internal Medicine and Surgery,Alaska Native Tribal Health Consortium,Anchorage,AK,USA.
authors.forename: D
authors.initials: D
authors.lastname: Barrett
authors.affiliation: Departments of Internal Medicine and Surgery,Alaska Native Tribal Health Consortium,Anchorage,AK,USA.
authors.forename: S
authors.initials: S
authors.lastname: Westby
authors.affiliation: Arctic Investigations Program,Division of Preparedness and Emerging Infections,National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention,Anchorage,AK,USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Parkinson
mesh_terms: D001110:Arctic Regions / Q000453:epidemiology; D004415:Dyspepsia / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D017408:Guidelines as Topic; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D016480:Helicobacter pylori / Q000502:physiology*; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D010437:Peptic Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D015995:Prevalence
keywords: Antibiotic resistance; Helicobacter pylori; gastrointestinal infections; health policy