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Title: Bacteriological and serological control of H. pylori infection in patients with chronic gastritis and duodenal ulcer: results of four-year follow-up

Grażyna Gościniak, Elżbieta Poniewierka, Anna Przondo-Mordarska
Original articles
Polish Gastroenterology
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Helicobacter pylori, antibodies, reinfection

The aim of the investigation was to determine the frequency of reinfection after successful eradication of H. pylori and to study the usefulness of the serological test in four-year follow-up. Consideration was given to the correlation between H. pylori infection and antibody levels. Materials and methods: Sera and gastric mucosa samples were taken from 82 patients (aged 24 to 68) hospitalised at the Department of Gastroenterology, University of Medicine, Wrocław, in the period of 1990-1996. The patients received different schemes of dual therapy: colloidal bismuth in combination with metronidazole or erythromycin in 1990-1994 and PPI with amoxycillin in 1995-1996. All patients were subjected to bacteriological (culture, Gram stain) and serological examinations. Specimens were collected before treatment and after 3, 6, 12, 24, 36 and 48 months following their first therapy. The levels of specific IgG antibodies in the sera were determined by the ELISA test, using ultracentrifuged sonicated H. pylori as antigen. Results: In their first examination, all patients were found to be H. pylori positive and seropositive. After three months following termination of treatment they showed negative H. pylori cultures. During four-year follow-up, reinfection was detected in 46 out of 82 patients (56.1 %). In patients with chronić gastritis the frequen-cy of reinfection was lower (30.8%) than in patients with duodenal ulcer (50%). In the third or in the fourth year after eradication of H. pylori, reinfection was detected in 7 out of 82 patients (8.5%). In the group of patients with H. pylori eradication confirmed by bacteriological test, the antibody titre showed a continuing tendency to decrease. Each reinfection with H. pylori was concomitant with an increase of the antibody level, regardless of the time elapsed after the termination of treatment. Conclusions: Reinfection of H. pylori was observed at different time points of follow-up, but most frequently after 6 to 12 months following eradication. Each reinfection was concomitant with a noticeable increase of the IgG anti-H. pylori antibody titre. After four years following eradication of H. pylori, 70% of patients were still seropositive.