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H elicobacter pylori Recurrence after First‐ and Second‐Line Eradication Therapy in K orea: The Problem of Recrudescence or Reinfection
Author(s) -
Kim Seung Young,
Hyun Jong Jin,
Jung Sung Woo,
Koo Ja Seol,
Yim Hyung Joon,
Lee Sang Woo
Publication year - 2014
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/hel.12117
Subject(s) - helicobacter pylori , rapid urease test , medicine , esophagogastroduodenoscopy , urea breath test , gastroenterology , breath test , biopsy , surgery , helicobacter pylori infection , endoscopy
Background Recurrence of H elicobacter pylori ( H . pylori ) infection is the result of either recrudescence or reinfection. Annual recurrence rates per patient‐year of follow‐up have been reported to vary across countries. The aim of this study was to analyze recurrence rates of H . pylori after first‐line and second‐line eradication therapies in K orea. Materials and Methods From 2007 to 2010, 2691 patients with H . pylori infection received first‐line therapy and 573 patients who failed to respond to first‐line therapy received second‐line therapy. H . pylori infection and the success of eradication were assessed by endoscopic biopsy and rapid urease test or 13 C ‐urea breath test. All patients were advised to undergo 13 C ‐urea breath test or esophagogastroduodenoscopy with biopsy or rapid urease test 6 months after eradication, with annual follow‐up thereafter. Results The eradication rate of the first‐line therapy was 79.9% (1283/1605) and that of the second‐line therapy was 90.4% (394/436) by per protocol analysis. Annual recurrence rates sharply declined after 2‐year follow‐up. Annual recurrence rates within and after 2‐year follow‐up were 9.3 and 2.0% after first‐line therapy and those of second‐line therapy were 4.5 and 2.9%, respectively. Conclusions Annual recurrence rates of H . pylori showed a sharp decline after 2‐year follow‐up after eradication in K orean adults, which is not higher than that of W estern countries. Enough time interval after treatment (i.e., 2 years) is necessary to confirm eradication, and it would not be easy to distinguish between recurrence and recrudescence before 2 years without identifying H . pylori strains.