Alimentary TractRecrudescence and reinfection with Helicobacter pylori after eradication therapy in Bangladeshi adults☆,☆☆
Section snippets
Patients
The study was approved by the Ethics Committee and Institutional Review Board of the Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh. Some 105 patients (95 men, 10 women; mean age, 36.1 years; range, 18–68; mean, body mass index 19.5; range, 15.1–26.1) were recruited at the BIRDEM, Institute of Postgraduate Medicine & Research, and Dhaka Medical College Hospital. The study took place between September 1996 and April
Recrudescence of H. pylori infection
Of the 105 patients with duodenal ulcer disease that finished eradication treatment, 8 were still H. pylori–positive (CLO test, 13C-UBT, histology) 1 month after the end of the treatment period, yielding an eradication rate of 92% according to the 4-week rule. Culture and DNA typing confirmed that all of the strains were identical before and after eradication treatment. During the next 2 months, 7 other patients showed a recurrence of H. pylori infection, which was again documented to be caused
Discussion
Our study aimed to distinguish between recrudescence and true reinfection of H. pylori after eradication treatment, and demonstrates a high reinfection rate of 18% per year in Bangladeshi adults. Although the mode of transmission of H. pylori has not yet been elucidated, our data suggest that exposure of adults to H. pylori results in a high infection rate and that recent infection does not provide adequate protection against recurrence. Late recrudescence occurred within 3 months after
Acknowledgements
The authors thank Jürgen Drewe, University Hospital Basel, for his contribution to statistical analysis and Kathleen A. Bucher for editorial assistance.
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2013, Clinics and Research in Hepatology and GastroenterologyCitation Excerpt :More than 120 studies were published in the medical literature about recurrence of H pylori after successful eradication till today, and found a wide range of recurrence rates [5,6,14,33,34]. Recurrence of H. pylori is rare in developed countries such as Europe and the USA and more frequent in developing countries such as Peru, Brazil, Chile, Vietnam and Bangladesh, all of which are countries with a high prevalence of H. pylori infection [2,6,13–15,20,35–37]. In the US, Western Europe and Australia the rate of reinfection has ranged from 0 to 2.3%/year [38–44].
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Address requests for reprints to: Niklaus Gyr, M.D., Master of Public Health and Tropical Medicine, Department of Internal Medicine, University Hospital Basel, CH-4031 Basel, Switzerland. e-mail: [email protected]; fax: (41) 61-265-4300.
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Supported in part by a grant (32-45998.95) from the Swiss National Science Foundation, Swiss Agency for Development and Cooperation, Bern; Stanley Thomas Johnson Foundation, Bern; Roche Research Foundation, Basel; Freiwilligen Akademischen Gesellschaft, Basel; Ciba-Geigy Foundation, Basel; Sandoz Foundation, Basel, Switzerland.