This article is more than 5 years old. Information may no longer be current.
Recurrence risk factors important to consider in H. pylori eradication
Click Here to Manage Email Alerts
Among patients in Latin America who had a negative 13C-urea breath test after treatment for Helicobacter pylori infection, 11.5% experienced recurrence, researchers reported in the Journal of the American Medical Association.
“Although gastric cancer rates are declining in some areas, the number of deaths is expected to increase over the coming decades due to growing and aging populations in high-incidence regions such as Latin America and eastern Asia,” the researchers wrote. “H. pylori infects more than half of the world’s adult population and chronic infection with this bacterium is the dominant risk factor for gastric cancer.”
The study included a cohort of patients from Latin America who had a moderate or high risk for gastric cancer. The original study was to compare three H. pylori eradication regimens. For this study, participants were retested for H. pylori, and the researchers evaluated risk for reinfection and factors that affected eradication effectiveness.
Among 1,133 participants who had a negative 13C-urea breath test (UBT) after treatment, 1,091 returned in 1 year. Among those, 125 had a positive UBT test at 1 year, for a recurrence risk of 11.5% (95% CI, 9.6-13.5). Study site, number of children in the household and nonadherence to therapy were associated with recurrence risk, but the treatment type was not. There was no difference in recurrence for the three different regimens tested.
After initial treatment, 281 patients had a positive UBT test, and 244 of these returned in 1 year. Of those, 93 had a negative UBT test at 1 year. Among the 138 patients who were re-treated, 93 had a negative UBT test at 1 year.
“Our results indicate that geographic site, demographic factors, adherence to initial therapy and infection recurrence may be as important as the choice of antibiotic regimen in H. pylori eradication interventions,” the researchers wrote. “Ongoing research initiatives are needed, given the expected increase in the gastric cancer burden in Latin America over the next 2 decades, evidence that H. pylori infection is the dominant risk factor and evidence that eradication reduces gastric cancer risk.”
Disclosure: The researchers reported no relevant financial disclosures.
Click Here to Manage Email Alerts