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.