Accuracy of Seven Different Tests for the Diagnosis of<i>Helicobacter pylori</i>Infection and the Impact of H<sub>2</sub>-Receptor Antagonists on Test Results

Lerang, Frode; Moum, Bjørn; Mowinckel, Petter; Haug, Jon Birger; Ragnhildstveit, Eivind; Berge, Travis J.; Bjørneklett, A

doi:10.1080/00365529850170982

Cited by 59 publications

(12 citation statements)

References 14 publications

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“…The reliability of serological kits for H. pylori infection has been widely confirmed [21], contributing to the reputation of serology as a simple, minimally invasive and inexpensive diagnostic and screening test. The best available serology test at the time of the study was the Pyloriset® an EIA-G from Orion Diagnostica, Espoo, Finland, with a specificity of 79–91% as assessed in previous studies in the Netherlands, including patients on acid suppressive therapy [22–24]. This specificity correlates well with our finding that in the placebo group, H. pylori could not be confirmed by culture or histology in 21% of the IgG positive patients.…”

Section: Conclusion and Discussionsupporting

confidence: 79%

“…A serum sample was considered positive for IgG antibodies to H. pylori if the test result was ≥250 International Units (IU). This assay has been assessed, in a population similar to the population in the presented trial, and has proven a sensitivity and specificity in the Netherlands of 98–100% and 79–85%, even in patients on acid suppressive therapy [15–17]. The study protocol was approved by research and medical ethics committees of all participating centers and all patients gave written informed consent.…”

Section: Methodsmentioning

confidence: 99%

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Efficacy of serology driven “test and treat strategy” for eradication of H. pylori in patients with rheumatic disease in the Netherlands

Leest

Steen

Lems

et al. 2011

Eur J Clin Microbiol Infect Dis

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The treatment of choice of H. pylori infections is a 7-day triple-therapy with a proton pump inhibitor (PPI) plus amoxicillin and either clarithromycin or metronidazole, depending on local antibiotic resistance rates. The data on efficacy of eradication therapy in a group of rheumatology patients on long-term NSAID therapy are reported here. This study was part of a nationwide, multicenter RCT that took place in 2000–2002 in the Netherlands. Patients who tested positive for H. pylori IgG antibodies were included and randomly assigned to either eradication PPI-triple therapy or placebo. After completion, follow-up at 3 months was done by endoscopy and biopsies were sent for culture and histology. In the eradication group 13% (20/152, 95% CI 9–20%) and in the placebo group 79% (123/155, 95% CI 72–85%) of the patients were H. pylori positive by histology or culture. H. pylori was successfully eradicated in 91% of the patients who were fully compliant to therapy, compared to 50% of those who were not (difference of 41%; 95% CI 18–63%). Resistance percentages found in isolates of the placebo group were: 4% to clarithromycin, 19% to metronidazole, 1% to amoxicillin and 2% to tetracycline.

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Section: Conclusion and Discussionsupporting

confidence: 79%

Section: Methodsmentioning

confidence: 99%

Efficacy of serology driven “test and treat strategy” for eradication of H. pylori in patients with rheumatic disease in the Netherlands

Leest

Steen

Lems

et al. 2011

Eur J Clin Microbiol Infect Dis

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“…The reported sensitivity and specificity of serology measuring IgG antibodies is 80–100% and 69–95%, respectively [14–16]. Reported sensitivity and specificity for UBT is 81–100% and 80–98%, respectively [14–16, 18, 19]. Differences between studies may in some instances be explained by differences in methodology and the choice of gold standard.…”

Section: Introductionmentioning

confidence: 99%

“…Depending on the choice of gold standard, the sensitivity and specificity of RUT is 80–95% and 90–100%, respectively, [14–16, 18]. Histological examination has a sensitivity of 83–95% and a specificity of 90–100%, respectively [15, 16, 18]. For culture, the reported sensitivity and specificity is 80–90% and 95–100%, respectively [15, 16].…”

Section: Introductionmentioning

confidence: 99%

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Reliability of Diagnostic Tests forHelicobacter pyloriInfection

Redéen

Petersson

Törnkrantz

et al. 2011

Gastroenterology Research and Practice

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Introduction. Helicobacter pylori (H. pylori) infection is very common worldwide. A reliable diagnosis is crucial for patients with H. pylori-related diseases. At followup, it is important to confirm that eradication therapy has been successful. There is no established gold standard for the diagnosis of H. pylori infection. Material and Methods. A sample of 304 volunteers from the general population was screened for H. pylori infection with serology, 13C-urea breath test (UBT), rapid urease test (RUT) on fresh biopsy, culture from biopsy, and histological examination. Culture was used as gold standard. Results. The sensitivity was 0.99 for serology, 0.90 for UBT, 0.90 for RUT, and 0.90 for histological examination. Corresponding specificities were 0.82, 0.99, 0.98, and 0.97, respectively. The accuracy was 0.86 for serology, 0.96 for UBT, 0.95 for RUT, 0.93 for culture, and 0.95 for histology. There was a strong correlation between the results of UBT and the histological scores of H. pylori colonisation as well as between the results of UBT and the scores of RUT. Conclusion. There were only minor differences in accuracy between the three invasive tests for H. pylori infection in this population. RUT may be recommended as the first choice since a result is obtained within hours. The accuracy of UBT was comparable to the invasive tests, and it is recommended for situations when endoscopy is not needed.

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Non-invasive diagnostic tests forHelicobacter pyloriinfection

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Takwoingi

Siddique

et al. 2018

Cochrane Database of Systematic Reviews

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In people without a history of gastrectomy and those who have not recently had antibiotics or proton ,pump inhibitors, urea breath tests had high diagnostic accuracy while serology and stool antigen tests were less accurate for diagnosis of Helicobacter pylori infection.This is based on an indirect test comparison (with potential for bias due to confounding), as evidence from direct comparisons was limited or unavailable. The thresholds used for these tests were highly variable and we were unable to identify specific thresholds that might be useful in clinical practice.We need further comparative studies of high methodological quality to obtain more reliable evidence of relative accuracy between the tests. Such studies should be conducted prospectively in a representative spectrum of participants and clearly reported to ensure low risk of bias. Most importantly, studies should prespecify and clearly report thresholds used, and should avoid inappropriate exclusions.

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Accuracy of Seven Different Tests for the Diagnosis ofHelicobacter pyloriInfection and the Impact of H₂-Receptor Antagonists on Test Results

Abstract: Culture, UBT, and IgG serology were all superior to the other four tests in diagnosing H. pylori infection. Invasive urease-based tests were less accurate in patients receiving H2RAs.

Cited by 59 publications

References 14 publications

Efficacy of serology driven “test and treat strategy” for eradication of H. pylori in patients with rheumatic disease in the Netherlands

Efficacy of serology driven “test and treat strategy” for eradication of H. pylori in patients with rheumatic disease in the Netherlands

Reliability of Diagnostic Tests forHelicobacter pyloriInfection

Non-invasive diagnostic tests forHelicobacter pyloriinfection

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Accuracy of Seven Different Tests for the Diagnosis ofHelicobacter pyloriInfection and the Impact of H2-Receptor Antagonists on Test Results

Abstract: Culture, UBT, and IgG serology were all superior to the other four tests in diagnosing H. pylori infection. Invasive urease-based tests were less accurate in patients receiving H2RAs.

Cited by 59 publications

References 14 publications

Efficacy of serology driven “test and treat strategy” for eradication of H. pylori in patients with rheumatic disease in the Netherlands

Efficacy of serology driven “test and treat strategy” for eradication of H. pylori in patients with rheumatic disease in the Netherlands

Reliability of Diagnostic Tests forHelicobacter pyloriInfection

Non-invasive diagnostic tests forHelicobacter pyloriinfection

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Accuracy of Seven Different Tests for the Diagnosis ofHelicobacter pyloriInfection and the Impact of H₂-Receptor Antagonists on Test Results