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These facts suggested that an immature immune response or tolerance to H. pylori exists in childhood and serodiagnosis of H. pylori infection is less useful in children aged below 10.

The consecutive follow up of HpSA, but not the one-point test, might be useful to diagnose persistent colonization of H. pylori in young infants, and some infants seemed to acquire H. pylori infection in the first year of life. These results should be taken into account for prevention and treatment strategies for H. pylori infection in infants.