Helicobacter pylori Reinfection in Brazilian Patients with Peptic Ulcer Disease: A 5-Year Follow-Up

Department of Gastroenterology, University of São Paulo Medical School, São Paulo, Brazil.
Helicobacter (Impact Factor: 4.11). 02/2010; 15(1):46-52. DOI: 10.1111/j.1523-5378.2009.00734.x
Source: PubMed


The Helicobacter pylori reinfection seems to be higher in developing countries, than in developed ones. The aim of the study was to determine the annual recurrence rate of H. pylori, in Brazilian patients with peptic ulcer disease, in a 5-year follow-up.
Patients, with peptic ulcer disease diagnosed by upper digestive endoscopy (UDE) and H. pylori infection verified by histological analysis, rapid urease test, polymerase chain reaction, and urea breath test (UBT), were treated for bacterial eradication. The cure of the infection was verified using the same tests, 3 months after. Clinical evaluation and UBT were performed after sixth and ninth month. After 1 year of follow-up, UBT and UDE were repeated. Up to the fifth year, patients were assessed twice a year and an UBT was performed annually. The patients included and all the reinfected were tested for 15 different genes of the H. pylori.
One hundred and forty-seven patients were followed: 19 for 1 year, eight for 2 years, four for 3 years, five for 4 years, and 98 for 5 years, totaling 557 patients/years. Recurrence did not occur in the first year. In the second year, two patients were reinfected; in the third, four patients; in the fourth, three patients; and in the fifth, one patient. The total of reinfected patients was 10. The annual reinfection rate was 1.8%.
Brazil presents a low prevalence of H. pylori reinfection, similar to the developed countries.

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Available from: Rejane Mattar, Feb 26, 2015
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    • "H. pylori eradication treatment is always high cost and complex, with limited efficiency of 88% [33]. The number of cases of functional dyspepsia responsive to treatment is low [34], as only 50% of ulcer patients attain symptom resolution [35,36], whereas the symptoms of patients with reflux disease do not improve with treatment [37]. Therefore, the test and treat strategy may not be adequate for developing countries, which usually have very high prevalence of H. pylori infection and low level of resources for health care. "
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