Long-term follow-up of Helicobacter pylori reinfection and its risk factors after initial eradication: a large-scale multicentre, prospective open cohort, observational study

Abstract

Helicobacter pylori (H. pylori) recurrence remains a significant public health concern. The study aimed to assess H. pylori reinfection rate and identify its risk factors in China. This prospective open cohort, observational study was performed at 18 hospitals across 15 provinces in China. Consecutive patients who received the successful initial eradication during 1 January 2012 and 31 December 2018 were eligible for enrolment. H. pylori recurrence was defined as reinfection that occurred at more than the 12-month interval after successful initial eradication. Surveyed risk factors that might be associated with reinfection were preliminarily estimated by log-rank test and further determined by Cox regression model to calculate the hazard ratio (HR) and 95% confidence interval (CI). A total of 5193 subjects enrolled in the study. The follow-up intervals varied from 6 to 84 months with a general follow-up rate of 67.9%. Annual reinfection rate was 1.5% (95% CI: 1.2-1.8) per person-year. H. pylori reinfection was independently associated with the following five risk factors: minority groups (HR = 4.7, 95% CI: 1.6-13.9), the education at lower levels (HR = 1.7, 95% CI: 1.1-2.6), a family history of gastric cancer (HR = 9.9, 95% CI: 6.6-14.7), and the residence located in Western China (HR = 5.5, 95% CI: 2.6-11.5) following by in Central China (HR = 4.9, 95% CI: 3-8.1) (all P < 0.05). Reinfection rate of H. pylori in China is relatively low. Patients with specific properties of ethnic groups, education level, family history, or residence location appear to be at higher risk for reinfection.

Helicobacter pylori Recurrence after Eradication Therapy in Jiangjin District, Chongqing, China

“…The recurrence rate in the present study was a little higher than that reported previously, which may be caused by many factors, such as location, economic level, scheme selection, drug compliance, and detection method. The latest multicenter prospective study has suggested that ethnic groups, education level, family history, and residence location are independent risk factors for H. pylori recurrence Gastroenterology Research and Practice [26]. The authors found that the recurrence rate of the residence located in Western China was significantly higher than that of other places, which may partially explain the high recurrence rate of H. pylori infection in the present study, since Chongqing is a western city in China.…”

Review: Epidemiology of Helicobacter pylori

“…In a large cohort from South Korea (10 468 eradicated subjects), reinfection of H pylori was calculated to occur at the rate of 3.06% per person‐year 28 . In a multi‐centre prospective, observational study in China involving 5193 subjects, the annual reinfection rate was 1.5% 29 . Reinfection was associated with the following risk factors: minority groups (HR = 4.7, 95% CI, 1.6‐13.9), a low level of education (HR = 1.7, 95% CI, 1.1‐2.6), a family history of gastric cancer (HR = 9.9, 95% CI, 6.6‐14.7), and the residence located in Western China (HR = 5.5, 95% CI, 2.6‐11.5) following by Central China (HR = 4.9, 95% CI, 3‐8.1) (all P < .05) 29 …”

Effect of Helicobacter Pylori eradication on patients with ITP: a meta-analysis of studies conducted in the Middle East

“…It is also associated with mucosa-associated lymphoid tissue (MALT) lymphoma, although the transmission pattern of this pathogen is not completely understood [ 25 , 26 ]. Overall, it is widely known that H. pylori is transmitted through oral-oral, fecal-oral, and gastro-oral routes [ 27 ]. As a highly prevalent infection, H. pylori is commonly acquired in early stages of life and grows in digestive tract and stays in the host’s body for the rest of its life [ 28 , 29 ].…”