Detección del antígeno de helicobacter pylori en heces para el diagnóstico inicial de la infección y para la confirmación de su erradicación tras el tratamiento

Medicina Clínica (Impact Factor: 1.42). 12/2002; 118(11):401–404. DOI: 10.1016/S0025-7753(02)72402-0


Recently, a new diagnostic method based on the detection of Helicobacter pyloriantigen in stools (HpSA) has been developed. Our aim was to prospectively evaluate the accuracyof HpSA both in the initial diagnosis of H. pylori infection and in the confirmation of theeradication after treatment.

Patients and method
Thirty dyspeptic patients were prospectively evaluated. During endoscopy,biopsies for histology and rapid urease test were obtained, and a 13C-urea breath test was performed.HpSA was determined by radioimmunoassay (Premier Platinum HpSA). Infected patientswere administered H. pylori eradication treatment, and breath test and HpSA were performedagain 4 weeks after finishing the therapy. Gold standard for H. pylori infectionpre-treatment was based on rapid urease test, histology and breath test, whereas 13C-urea breathtest was considered the post-treatment gold standard.

Pre-treatment H. pylori prevalence was 57%. Eradication was achieved in 85% of patients.The area under ROC curve for HpSA pre-treatment was 0.98. Cut-off points with bestpre-treatment diagnostic accuracy were those between 0.10 and 0.12: positive likelihood ratio(LR), ∞; negative LR, 0.06; 94% sensitivity (95% CI, 73-99%), 100% specificity (75-100%),100% positive predictive value (81-100%) and 93% negative predictive value (66-100%). Aftertreatment, the area under ROC curve was 1, and all cut-off points between 0.10 and 0.18had 100% diagnostic accuracy. HpSA levels decreased from 0.94 (0.9) to 0.08 (0.02) (p < 0.01) in patients with H. pylori eradication success.

HpSA test can be considered an accurate, non-invasive method for the diagnosisof H. pylori infection both in untreated patients and in the confirmation of H. pylori eradicationafter treatment.

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