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 18 February 2018

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News

H. pylori recrudescence and reinfection after eradication therapy

In Bangladesh, reinfection rates with Helicobacter pylori after eradication therapy are high, according to research published in the October issue of Gastroenterology.

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A team from Switzerland and Bangladesh investigated the rates of recrudescence and reinfection with Helicobacter pylori after eradication therapy in Bangladeshi adults.

A total of 105 Bangladeshi patients with H. pylori infection and duodenal ulcer disease were treated with a triple therapy.

Follow-up included 13C-urea breath tests, endoscopy, and biopsy-based tests.

Annual H. pylori reinfection rate was 13%.
Gastroenterology

In reinfected patients, genomic typing compared pretherapeutic and post-therapeutic strains.

Recrudescence, associated with nitroimidazole-based treatment, occurred in 15 of 105 patients (14%) within the first 3 months. However, it only occurred in 8 of 105 patients tested positive 4 weeks after therapy ended.

True reinfection was diagnosed in 11 of 105 patients, between 3 and 18 months after therapy.

Researchers found that the annual reinfection rate was 13%, based on a total follow-up of 85 patient years.

Ulcer relapse occurred in 2 of 15 (13%) recrudescence cases and in 6 of 11 (55%) reinfection cases. It also occurred in 4 of 73 (5%) H. pylori-negative patients.

Pius Hildebrand, of the University Hospital, Basel, Switzerland, said on behalf of fellow colleagues, "In Bangladesh, late recrudescence of H. pylori after eradication therapy occurs within the first 3 months."

"The reinfection rate is high, and might influence cost-benefit analyses for determining diagnostic and therapeutic procedures," it was concluded.

Gastroenterology 2001; 121 (4): 792-8
17 October 2001

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