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  1. J-M Liou1,2,
  2. J-T Lin1,3,
  3. C-Y Chang3,
  4. M-J Chen1,
  5. Y-C Lee1,
  6. M-S Wu1,4
  1. 1Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
  2. 2Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan
  3. 3Department of Internal Medicine, E-DA Hospital and I-Shou University, Kaohsiung County, Taiwan
  4. 4Department of Primary Care Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
  1. Correspondence to Professor Ming-Shiang Wu, Department of Internal Medicine and Primary Care Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, No 7, Chung-Shan S. Road, Taipei 100, Taiwan; mingshiang{at}ntu.edu.tw

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We greatly appreciated Dr Gatta and colleagues'1 interest and valuable comments to our study published in this journal.2 Our response to their comments were as follows. First, 7 out of the 1173 patients were excluded because of positive culture alone in the screening for eligibility. Second, the successful rate of culture in naïve patients was approximately 74.5% in this study. Although the specificity of culture was high (near 100%), the sensitivity was usually lower (ranged from 55% to 90%) in the literature.3 Factors that might affect the sensitivity of culture for Helicobacter pylori included (1) a delay in transporting the specimen to the laboratory, (2) insufficient number of biopsied specimens, (3) exposure of the bacteria to an aerobic environment, (4) the presence of gastric …

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