Noninvasive Diagnosis of <i>Helicobacter pylori</i> Infection: A Review

Breslin, Niall; O’Moráin, Colm

doi:10.1111/j.1523-5378.1997.tb00070.x

Cited by 21 publications

(11 citation statements)

References 42 publications

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“…Serology is one of the well accepted diagnostic methods to screen for an infection with Helicobacter pylori, especially in epidemiological studies [1,2]. Most of the enzyme-linked immunosorbent assays (ELISA) or immunoblot tests, which are used routinely, exhibit sensitivity or speci¢city values comparable with those of histology or urea breath tests [3,4]. However, for diagnosis of treatment success 0928-8244 / 99 / $20.00 ß 1999 Federation of European Microbiological Societies.…”

Section: Introductionmentioning

confidence: 99%

Impact of ELISA and immunoblot as diagnostic tools one year after eradication of Helicobacter pylori in a multicentre treatment study

Kist¹

1999

FEMS Immunology and Medical Microbiology

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The performance of serological tests for Helicobacter pylori infections is hampered by the persistence of antibodies after eradication therapy or spontaneous healing. Detection of different antigens or immunoglobulin classes might have an impact on the validity of serodiagnosis. The aim of this study was to assess the decrease in IgA and IgG antibody levels after eradication of H. pylori. Serum samples of 242 patients with active duodenal ulcer were tested with the ELISA and the immunoblot (IB) techniques for H. pylori-specific IgA and IgG antibodies before therapy and 1 year after successful eradication. From a total of 81 patients paired sera were available. At the end of the follow-up period ELISA antibody titres from the IgA class had decreased from a mean value of 6.69 to 4.26 units (P = 0.0001), and IgG class antibody titres from a mean value of 21.9 to 12.1 units (P = 0.0001). Regarding seroreversion, from 34 initially IgA positive sera 16 (47%), and from 74 IgG positive sera 18 (24%), had definitively reverted to 'negative'. One year after eradication, when tested with the immunoblot, the antibody responses against specific antigens of 37% IgA-positive sera (23/62) and 8% IgG-positive sera (6/78) reverted to 'negative', compared to a seroreversion rate of 27% of the anti-CagA IgA-positive sera (18/67) and of 9% of the anti-CagA IgG-positive sera (7/79). In conclusion, despite an overall significant decrease of H. pylori antibodies, both tests cannot be recommended for monitoring treatment success.

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Section: Introductionmentioning

confidence: 99%

Impact of ELISA and immunoblot as diagnostic tools one year after eradication of Helicobacter pylori in a multicentre treatment study

Kist¹

1999

FEMS Immunology and Medical Microbiology

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“…pylori serological tests have been evaluated against criterion biopsy standards, including histology, culture, and Campylobacter-like organism tests (1,6,7,19). We are unaware, however, of detailed investigation into the reliability of a commonly used H. pylori serological test.…”

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confidence: 99%

Reliability of Helicobacter pylori and CagA Serological Assays

Everhart

Kruszon-Moran

Pérez-Pérez

2002

Clin Vaccine Immunol

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Background serological assays for Helicobacter pylori are commonly used without knowledge of reliability. This information is needed to define the ability of serological tests to determine either new cases of infection or loss of infection in longitudinal studies. We evaluated the reproducibility and the interrelationships of serological test results for H. pylori and cytotoxin-associated gene product A (CagA) enzyme-linked immunoassays within a subset of participants in a population-based study. Stored samples from 1,229 participants in the third U.S. National Health and Nutrition Examination Survey were replicate serologically tested for H. pylori and CagA. Overall disagreement was 3.4% between duplicate tests for H. pylori (or 2.3% if equivocal results were disregarded). Six percent of samples positive on the first test had an immune serum ratio at least 30% lower on repeat testing. The odds ratio for H. pylori seropositivity on retesting was 2.8 (95% confidence interval [CI] ‫؍‬ 1.8 to 4.5) when CagA serology was positive versus when it was negative. CagA antibody was found among 47.8% of H. pylori-equivocal and 7.0% of H. pylori-negative samples. CagA-positive yet H. pylorinegative samples were more likely to occur among Mexican Americans (odds ratio, 5.2; 95% CI ‫؍‬ 2.4 to 11.4) and non-Hispanic blacks (odds ratio, 5.5; 95% CI ‫؍‬ 2.3 to 13.0) than among non-Hispanic whites. Relying on repeated H. pylori serological tests over time to determine infection rates may result in misinterpretation due to limits in test reproducibility. CagA testing may have a role in verifying infection.

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“…However, false-positive results can occur if the patient is colonized with other urease producing organisms (33). This is rarely a problem, except in patients who have no acid secretions (55). Patients scheduled for a urea breath test should not be on any antisecretory drugs for at least 2 weeks prior to the test (33).…”

Section: Urea Breath Testsmentioning

confidence: 99%

Laboratory tests for the evaluation of Helicobacter pylori infections

Nakamura

2001

Clinical Laboratory Analysis

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Helicobacter pylori is a highly motile bacterium with multiple unipolar flagella, and it produces the urease enzyme. The flagella and urease are the virulence factors of H. pylori. H. pylori often establishes a chronic infection in the stomach that may lead to gastric and duodenal ulcers, gastric cancers, gastric lymphomas, and other gastrointestinal diseases. There are several different invasive and noninvasive clinical laboratory tests for H. pylori. Laboratory testing is not indicated in asymptomatic patients and should be considered only if treatment of H. pylori infection is planned. Invasive tests for H. pylori, such as tissue histology, culture, and rapid urease tests, are used if an endoscopy is performed on the patient. The noninvasive tests for H. pylori, such as enzyme antibody and urea breath tests, are recommended in patients whose symptoms do not warrant endoscopy. The urea breath test is very useful and is recommended to evaluate effectiveness in the eradication and treatment of H. pylori infections. Nucleic acid tests can complement other diagnostic procedures, and are useful in evaluating fixed biopsy tissue, environmental samples, gastric juices, oral secretions, and stool samples.

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Noninvasive Diagnosis of Helicobacter pylori Infection: A Review

Cited by 21 publications

References 42 publications

Impact of ELISA and immunoblot as diagnostic tools one year after eradication of Helicobacter pylori in a multicentre treatment study

Impact of ELISA and immunoblot as diagnostic tools one year after eradication of Helicobacter pylori in a multicentre treatment study

Reliability of Helicobacter pylori and CagA Serological Assays

Laboratory tests for the evaluation of Helicobacter pylori infections

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