Helicobacter pylori infection in Finland

Rautelin, Hilpi; Kosunen, Timo U.

doi:10.1080/07853890310020293

Cited by 18 publications

(26 citation statements)

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“…A rate of 0.5 -1.0% has been estimated in the latter from seroepidemiological studies [1,2] . The infection shows an age-dependent pattern, being rare among children but with an increasing rate of infection among older age groups [3] . Socioeconomic conditions in childhood are strongly inversely correlated with the risk of infection [1] .…”

Section: Introductionmentioning

confidence: 99%

Helicobacter pylorieradication therapy: indications, efficacy and safety

Kwok

Lam

Katelaris

et al. 2008

Expert Opinion on Drug Safety

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Background : Helicobacter pylori infects up to half of the world's population. It remains the major cause of peptic ulcer disease and is recognised as a carcinogen for its role in gastric carcinogenesis. Successful eradication of the bacteria is associated with improved health outcomes including fewer dyspeptic symptoms, reduced peptic ulcer recurrence and rebleeding, reduced peptic ulcer risk with NSAIDs and as a cure for low-grade gastric MALT lymphoma. The risk of gastric cancer is reduced in those without premalignant mucosal abnormalities at the time of eradication. Objective : This review outlines the current indications and options for therapy of H. pylori with particular reference to drug-induced adverse events associated with treatment. Methods : The indications for H. pylori eradication are evidence-based and in accordance with recent consensus statements and recommendations. The eradication treatment is based on numerous clinical trials and meta-analyses. Results/conclusion : Eradication therapy, in general, is safe and well tolerated. Antibiotic therapy may be associated with significant drug adverse reactions, especially gastrointestinal symptoms.

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Section: Introductionmentioning

confidence: 99%

Helicobacter pylorieradication therapy: indications, efficacy and safety

Kwok

Lam

Katelaris

et al. 2008

Expert Opinion on Drug Safety

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“…One of the main factors in Finland is the decreased prevalence of H. pylori infection during the last decades. 9,10,24 The role of NSAIDs as an aetiological factor has become more important, but the use of proton pump inhibitors has shown to prevent ulcers in long-term users of NSAIDs. 25 Recurrence Recurrence of PUD was associated with multi-drug use ( Figure 5) and, surprisingly, the use of PPIs, even before the first ulcer was diagnosed.…”

Section: Complicationsmentioning

confidence: 99%

Incidence and complications of peptic ulcer disease requiring hospitalisation have markedly decreased in Finland

Malmi

Kautiainen

Virta

et al. 2014

Aliment Pharmacol Ther

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“…A total of 97% of the subjects with H. pylori infection have elevated levels of specific serum IgG and/or IgA antibodies when highly accurate and specific quantitative enzyme immunoassay based tests are used 23–26. Successful eradication of the infection is followed by an at least 40–50% decrease of antibody titers within 4–12 months 23–25…”

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confidence: 99%

Gastric cancers in Finnish patients after cure of Helicobacter pylori infection: A cohort study

Kosunen

Pukkala

Sarna

et al. 2010

Intl Journal of Cancer

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Helicobacter pylori infection is associated with gastric cancer. A total of 97% of the infected subjects have elevated levels of H. pylori antibodies. The antibody titers have been shown to decline rapidly (40-60% within 4-12 months) only after successful eradication therapy. We allocated 26,700 consecutive patients tested during 1986-1998 for H. pylori antibodies to 3 subcohorts: seropositive patients with rapidly falling antibody titers (Hp1CURED, n 5 3,650), seropositive patients where no serological information indicating cure was obtained (Hp1NoInfo, n 5 11,638) and seronegative patients (Hp-, n 5 11,422). In the subcohorts, the standardised incidence ratios (SIRs) with 95% confidence intervals (CI) were defined for subsequent cancers of stomach, pancreas, colon, rectum, breast and prostate separately and for all cancers except stomach combined. The mean follow-up time was 10.1 years and the number of gastric cancers was 72. For the Hp1CURED, the SIR for gastric cancers for the first 5 follow-up years was 1.62 but decreased from the sixth follow-up year thereon to 0.14 (CI: 0.00-0.75). Likewise, the risk ratio, defined in a Poisson regression analysis using the Hp1NoInfo group as the reference, decreased from 1.60 to 0.13 (CI: 0.02-1.00, p 5 0.049). The SIR for Hp-was not significantly higher than that for Hp1NoInfo for any of the cancers analysed. To conclude, cured H. pylori infection led to a significantly decreased incidence of gastric cancers from the sixth follow-up year. Advanced atrophic gastritis would be a plausible contributor to the elevated SIR in elderly Hp-patients.Chronic gastritis caused by Helicobacter pylori is associated with peptic ulcer disease, 1 noncardia gastric cancer, 2-5 primary low-grade B-cell gastric lymphoma of mucosa-associated lymphoid tissue type (MALT lymphoma) 6 and in some patients with cardia cancer in association with atrophic gastritis. 7 The annual incidence of gastric cancer in patients with premalignant lesions is 0.1% for atrophic gastritis, 0.25% for intestinal metaplasia, 0.6% for mild-to-moderate dysplasia and 6% for severe dysplasia within 5 years from the baseline according to a Dutch nationwide quantification. 8 Successful eradication of H. pylori infection leads to, besides healing of gastritis, permanent cure of peptic ulcer disease 9 and regression of the majority of MALT lymphomas. 6 Follow-up studies have also shown the regression of precancerous lesions after eradication therapy 10-12 and limited success in the prevention of the development of gastric cancer, [13][14][15][16][17][18][19] even in patients with resected early gastric cancer. 20 The general problems of therapeutic trials and the relatively long time needed to collect evidence for the beneficial effect of successful therapy on carcinogenesis and gastric cancer have been reviewed by Fuccio et al. 21,22 The latter review includes a meta-analysis of 6 randomised trials aimed to reduce the risk for gastric cancer by the eradication of H. pylori infection. Some of the studies were still ongoin...

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Helicobacter pylori infection in Finland

Cited by 18 publications

References 50 publications

Helicobacter pylorieradication therapy: indications, efficacy and safety

Helicobacter pylorieradication therapy: indications, efficacy and safety

Incidence and complications of peptic ulcer disease requiring hospitalisation have markedly decreased in Finland

Gastric cancers in Finnish patients after cure of Helicobacter pylori infection: A cohort study

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