Association between seropositivity of antibodies against hepatitis a virus and Helicobacter pylori.

Abstract

Abstract. Helicobacter pylori and hepatitis A virus (HAV) are documented to share common transmission routes including fecal-oral. This study examined the association between seropositivity of antibodies against H. pylori (anti-HP) and HAV (anti-HAV) via a community-based survey of 40 randomly selected kindergartens in 10 urban and 10 rural areas. Serum samples from 2,047 healthy preschool children and 104 teachers were screened for anti-HP by enzyme-linked immunosorbent assay, and for anti-HAV by microparticle enzyme immunoassay. In children, a low prevalence of anti-HAV (0.44%) was found, in contrast to a high prevalence in their teachers (78.8%); anti-HP seroprevalence was 6.4% for children and 30.8% for teachers. Anti-HAV and anti-HP seropositivities were significantly associated in teachers after adjustment for age, sex, and residential area through multiple logistic regression analysis (multivariate-adjusted odds ratio ϭ 7.3; 95% confidence interval [CI] ϭ 1.4-36.8, P Ͻ 0.001). Our findings suggest that HAV and H. pylori may have shared transmission routes in central Taiwan 15 years or more ago, but not any recently.

Seroprevalence of <i>Helicobacter pylori</i> and Hepatitis A Virus among Children in Rural Central Taiwan

“…Because HAV is a sensitive marker of fecal exposure, correlation between HAV and H. pylori seropositivity rates would indicate similar modes of transmission for these 2 pathogens. However, although there was a significant association between the prevalence of anti-H. pylori antibodies and anti-HAV antibodies among teachers born before 1980, this was not true among children born after 1990, suggesting independent H. pylori and HAV transmission routes after 1990 (47). In fact, using the kappa statistic to measure seropositivity differences between H. pylori and HAV in 500 study subjects, 1 study reported that that was no evidence for a fecal-oral route of transmission for H. pylori (55).…”

“…Recent studies also showed significantly higher prevalence of anti-H. pylori antibodies among teachers compared to children 9-15 years of age (33,47), possibly due to improved socioeconomic and environmental conditions in Taiwan between the 1980s and recent years.…”

Helicobacter pylori and Hepatitis a Virus Infection in School‐Aged Children on Two Isolated Neighborhood Islands in Taiwan

“…The seroprevalence of HAV infection strikingly decreased from 89% in 1975 to 10% in 1991 among adolescents in the major urban city of Taiwan owing to economic success and public health education [30]. Pretolani et al suggested that both H. pylori and HAV infection may share a similar transmission pattern, which was also strongly supported by Fujisawa et al [31,32] However, negative association of H. pylori and HAV infection has been observed, which postulated that the fecal-oral route may not be the common transmission route of H. pylori [25,26,33]. The relationship between H. pylori and HAV transmission has been extensively discussed with controversial results.…”

“…However, some contradictory findings were reported against those associations [24,25]. The relationship of seroprevalence of H. pylori and HAV infection was studied in central Taiwan, which disclosed no significant association in school-aged children [26].…”

Serologic Evidence for Fecal–Oral Transmission of Helicobacter pylori

“…29 Further, acute infection with H. pylori during childhood is characterized by vomiting and thus gastro-oral transmission may be more common among children. 30 One of the limitations of our study was the high level of excluded children (53.3% of children < 10 years old excluded) due to missing serology, which may have biased OR estimates upward.…”