TY - JOUR
T1 - Helicobacter pylori Reinfection Is Common in Peruvian Adults after Antibiotic Eradication Therapy
AU - Soto, Giselle
AU - Bautista, Christian T.
AU - Roth, Daniel E.
AU - Gilman, Robert H.
AU - Velapatiño, Billie
AU - Ogura, Masako
AU - Dailide, Giedrius
AU - Razuri, Manuel
AU - Meza, Rina
AU - Katz, Uriel
AU - Monath, Thomas P.
AU - Berg, Douglas E.
AU - Taylor, David
N1 - Funding Information:
Financial support: Acambis; International Training and Research Program in Emerging Infectious Diseases, Fogarty International Center, National Institutes of Health (NIH) (training grant D43 TW 00910); NIH (grants AI38166, AI49161, DK53727, and P30 DK52574); The International Collaboration in Infectious Disease Research, NIH (grant U01 AI35894); Anonymous RG-ER Fund.
PY - 2003/11/1
Y1 - 2003/11/1
N2 - To characterize posttreatment recurrence of Helicobacter pylori in Peru, 192 adults with H. pylori-positive gastric biopsy specimens were monitored by 14C-Urea breath test, after eradication of H. pylori by use of amoxicillin, clarithromycin, and omeprazole. The cumulative risk of recurrence at 18 months was 30.3% (95% confidence interval, 21.4%-39.3%). Randomly amplified polymorphic DNA patterns and DNA sequence data established that, among 28 pairs of H. pylori isolates from pretreatment and recurrent infections, 6 (21%) were genetically similar, suggesting recrudescence of the previous infection, and 22 (79%) were different, suggesting reinfection with a new strain that differed from that involved in the initial infection. Eating mainly outside of the home was a risk factor for infection with a new strain (adjusted relative risk [RR], 5.07), whereas older age was a protective factor (adjusted RR, 0.20). Although an increase in the anti-H. pylori IgG antibody titer corresponded to recurrence, pretreatment and recurrent infections were similar with respect to quantitative culture colony counts and histologic characteristics, suggesting that neither prior eradication nor the memory immune response measurably alters the risk or burden of recurrent infection. Although eradication with antibiotics was successful, the high rate of reinfection suggests that treatment is unlikely to have a lasting public health effect in this setting.
AB - To characterize posttreatment recurrence of Helicobacter pylori in Peru, 192 adults with H. pylori-positive gastric biopsy specimens were monitored by 14C-Urea breath test, after eradication of H. pylori by use of amoxicillin, clarithromycin, and omeprazole. The cumulative risk of recurrence at 18 months was 30.3% (95% confidence interval, 21.4%-39.3%). Randomly amplified polymorphic DNA patterns and DNA sequence data established that, among 28 pairs of H. pylori isolates from pretreatment and recurrent infections, 6 (21%) were genetically similar, suggesting recrudescence of the previous infection, and 22 (79%) were different, suggesting reinfection with a new strain that differed from that involved in the initial infection. Eating mainly outside of the home was a risk factor for infection with a new strain (adjusted relative risk [RR], 5.07), whereas older age was a protective factor (adjusted RR, 0.20). Although an increase in the anti-H. pylori IgG antibody titer corresponded to recurrence, pretreatment and recurrent infections were similar with respect to quantitative culture colony counts and histologic characteristics, suggesting that neither prior eradication nor the memory immune response measurably alters the risk or burden of recurrent infection. Although eradication with antibiotics was successful, the high rate of reinfection suggests that treatment is unlikely to have a lasting public health effect in this setting.
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U2 - 10.1086/379046
DO - 10.1086/379046
M3 - Article
C2 - 14593583
AN - SCOPUS:0242468465
SN - 0022-1899
VL - 188
SP - 1263
EP - 1275
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 9
ER -