Short-Term Follow-Up by Serology of Patients Given Antibiotic Treatment for Helicobacter pylori Infection

Abstract

Helicobacter pylori serology and in particular enzyme-linked immunosorbent assays for the measurement of immunoglobulin G (IgG) antibody titers form an accurate means of diagnosing H. pylori infection in patients before treatment. H. pylori serology is of limited value in monitoring treatment because of the slow decline in antibody titers. In the present study we aimed to measure the most suitable moment after antibiotic treatment at which serology should be used to monitor treatment. Sixty-four patients who had nonulcer dyspepsia and H. pylori infection and who underwent upper gastrointestinal endoscopy because of persistent dyspeptic symptoms were included in the study. H. pylori cure was confirmed by histology and culture 5 weeks after the completion of the antibiotic treatment. Serological examination was performed before therapy and at 5 weeks, 10 weeks, and 1 year after the completion of antibiotic treatment. Diagnostic performance was assessed by receiver-operating characteristic analysis. The areas under the receiver-operating characteristic curves of the H. pylori antibody titers at 5 weeks, 10 weeks, and 1 year after the completion of treatment were 0.53 (95% confidence interval [CI], 0.36 to 0.69), 0.60 (95% CI, 0.43 to 0.76), and 0.78 (95% CI, 0.63 to 0.93), respectively. The areas under the receiver-operating characteristic curves of the changes in H. pylori IgG antibody titers at 5 weeks, 10 weeks, and 1 year after the completion of treatment in comparison with the pretreatment titers were 0.85 (95% CI, 0.72 to 0.97), 0.96 (95% CI, 0.89 to 1.0), and 1.0 (95% CI, not estimable), respectively. We conclude that serology forms a useful means of monitoring treatment in patients with nonulcer dyspepsia and H. pylori infection as early as 10 weeks and maybe even sooner after the completion of treatment for the infection.

Evaluation of Commercially AvailableHelicobacter pyloriSerology Kits: a Review

“…For evaluative purposes, the sensitivity and specificity are less useful (83). On the basis of the receiver operating characteristic (ROC) curve, we calculated the AURC, which is a measure for the diagnostic performance of a test (42). It is independent of cutoff points and reasonably immune to selection bias.…”

“…However, ROC curves and/or test result distributions were very sparsely presented in the publications. Fortunately, it is possible to make a fairly accurate estimation of the underlying ROC curve if one sensitivity and one specificity are mentioned (42). We think that this method is more appropriate for evaluation of the diagnostic performance of tests than the summary ROC (48).…”

Helicobacter pyloriAnti-CagA Antibodies: Prevalence in Symptomatic and Asymptomatic Subjects in Turkey

“…Serological tests are noninvasive and are used to detect immunoglobulin (Ig) G, IgA and IgM antibodies in the sera of H pyloriinfected subjects. The ELISA test is the most widely used test for the detection of such antibodies in epidemiological studies (4,21,22). Immunoblot assay enables the detection of antibodies against specified H pylori antigens, such as CagA and VacA antigens (21,23).…”

Use of a dry latex agglutination test to measure eradication of Helicobacter pylori infection

“… 7 A recent study showed that IgG titres for H. pylori fall sufficiently 10 weeks after therapy for treatment success to be established. 8 In this present study, less than half the patients had a sufficient decline in IgG antibody titres 8 weeks after treatment for cure of infection to be established. The latex test showed even less predictive power with only one‐third of patients giving a negative result at this time point.…”