Long‐term follow‐up of <scp>Helicobacter pylori</scp> eradication therapy in Vietnam: reinfection and clinical outcome

Wheeldon, T.-U.; Hoang, Thi Thu Ha; Phung, Dac Cam; Björkman, Anders; Granström, Marta; Sörberg, Mikael

doi:10.1111/j.1365-2036.2005.02408.x

Cited by 41 publications

(26 citation statements)

References 32 publications

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“…Low recurrence rate have been reported from South-east Asia (0%), China (1.1%) and Chile (4.2%) [9, 19, 20], but studies in some other countries have found much higher recurrence rates. In Vietnam, a mean follow-up of 11 months revealed a recurrence rate of 23.5% [21] and in Brazil the re-infection rate one year after eradication was 7.6% [22]. Recurrence rates in these reports are much higher than those reported from developed countries.…”

Section: Discussioncontrasting

confidence: 47%

Long-Term Re-Infection Rate after Helicobacter pylori Eradication in Bangladeshi Adults

et al. 2007

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Background and Aim: Bangladesh is a developing country with a very high prevalence of Helicobacter pylori infection, which has been ascribed to overcrowding and poor sanitary conditions. It has generally been accepted that the re-infection rate is higher in countries with a high prevalence of H. pylori infection. Short-term follow-up studies support this assumption but no long-term studies are available to confirm or refute this assertion. The present study was aimed to define the long-term H. pylori re-infection rate (6 years after successful eradication) in duodenal ulcer patients. Methods: In a previous study, 90 patients were successfully eradicated for H. pylori and followed-up for 24 months. 17/90 were found to be re-infected (18% re-infection rate per year in the first 12 months) [Gastroenterology 2001;792–798]. The remaining 73 patients were targeted for long-term follow-up. 26/73 were lost to follow-up; 6 symptomatic patients were tested H. pylori positive in the period between 24 and 60 months post-eradication. The remaining 41 patients were evaluated 72 months after successful eradication. The evaluation included clinical history taking, a ¹³C-urea breath test (UBT), and endoscopy. Results: Of the 41 H. pylori-eradicated patients analyzed after 72 months, 16 were H. pylori-positive. If the 6 patients, who were tested positive between 24 and 60 months, are added, the total re-infection cases amount to 22 subjects in the period between 24 and 72 months. Therefore, an overall annual re-infection rate 6 years after eradication of 5.02% can be calculated. Six of the 23 symptomatic patients had duodenal ulcer relapse, 5/6 were H. pylori re-infected and one was H. pylori-negative at 72 months post-treatment. Conclusion: The long-term annual H. pylori re-infection rate in Bangladeshi adults is markedly higher than in Western countries but lower than anticipated. In this study, duodenal ulcer relapse is clearly related to H. pylori re-infection.

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Section: Discussioncontrasting

confidence: 47%

Long-Term Re-Infection Rate after Helicobacter pylori Eradication in Bangladeshi Adults

et al. 2007

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“…The well-documented incidence of recurrent infection after antibiotic eradication in adults and children suggests that even adults continue to be exposed to H. pylori, at least in regions where the levels of infection are high (26,47,56). One patient in our study exhibited heterogeneity with all three tests for macrodiversity.…”

Section: Discussionmentioning

confidence: 74%

Genetic Analysis of Helicobacter pylori Strain Populations Colonizing the Stomach at Different Times Postinfection

et al. 2007

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Genetic diversity of the human gastric pathogen Helicobacter pylori in an individual host has been observed; whether this diversity represents diversification of a founding strain or a mixed infection with distinct strain populations is not clear. To examine this issue, we analyzed multiple single-colony isolates from two to four separate stomach biopsies of eight adult and four pediatric patients from a high-incidence Mexican population. Eleven of the 12 patients contained isolates with identical random amplified polymorphic DNA, amplified fragment length polymorphism, and vacA allele molecular footprints, whereas a single adult patient had two distinct profiles. Comparative genomic hybridization using whole-genome microarrays (array CGH) revealed variation in 24 to 67 genes in isolates from patients with similar molecular footprints. The one patient with distinct profiles contained two strain populations differing at 113 gene loci, including the cag pathogenicity island virulence genes. The two strain populations in this single host had different spatial distributions in the stomach and exhibited very limited genetic exchange. The total genetic divergence and pairwise genetic divergence between isolates from adults and isolates from children were not statistically different. We also analyzed isolates obtained 15 and 90 days after experimental infection of humans and found no evidence of genetic divergence, indicating that transmission to a new host does not induce rapid genetic changes in the bacterial population in the human stomach. Our data suggest that humans are infected with a population of closely related strains that vary at a small number of gene loci, that this population of strains may already be present when an infection is acquired, and that even during superinfection genetic exchange among distinct strains is rare.

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“…Spouse-spouse transmission would appear to be an obvious source of infection in adulthood [16,29] . In areas where the risk of contamination is high, reinfection can be prevented by eradication programs [30,31] . Lifestyle changes are recommended, but they are unlikely to occur in the short term.…”

Section: Discussionmentioning

confidence: 99%

H pylori : Treatment for the patient only or the whole family?

Sarı¹,

Can²,

Tunalı³

et al. 2008

WJG

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Long‐term follow‐up of Helicobacter pylori eradication therapy in Vietnam: reinfection and clinical outcome

Cited by 41 publications

References 32 publications

Long-Term Re-Infection Rate after Helicobacter pylori Eradication in Bangladeshi Adults

Long-Term Re-Infection Rate after Helicobacter pylori Eradication in Bangladeshi Adults

Genetic Analysis of Helicobacter pylori Strain Populations Colonizing the Stomach at Different Times Postinfection

H pylori : Treatment for the patient only or the whole family?

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