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High Exposure, Spontaneous Clearance, and Low Incidence of Active Helicobacter pylori Infection: The Sorbo San Basile Study
Author(s) -
Luzza Francesco,
Suraci Evelina,
Larussa Tiziana,
Leone Isabella,
Imeneo Maria
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.12133
Subject(s) - serology , medicine , incidence (geometry) , helicobacter pylori , clearance , breath test , population , helicobacter pylori infection , urea breath test , gastroenterology , antibody , immunology , environmental health , physics , optics , urology
Background A decreased incidence of H elicobacter pylori infection has been prospected to occur nowadays. Aim To evaluate the exposure to H . pylori , prevalence and incidence of active infection, and related risk factors in the general population. Methods In a small town of S outhern I taly (932 inhabitants), 595 (3–97 years) and 157 (12–82 years) subjects among those with no evidence of active H . pylori infection participated at baseline and 10 years later, respectively. A questionnaire was administered. Active H . pylori infection was assessed by 13 C ‐urea breath test ( UBT ). Serum V ac A and C ag A antibodies were determined. Results Of 518 subjects who were evaluated by both UBT and serology, 310 (59.8%) were UBT positive, 479 (92.4%) V ac A positive, and 369 (71.2%) C ag A positive. Subjects UBT negative and serology positive were 169 (32%), ranging 1 (14.2%) to 29 (82.8%) from last to first decades of life. Age, female gender, and people per room were independent risk factors for subjects UBT positive compared to those UBT negative and serology positive. Ten years later, subjects who became UBT positive were four of 157 (0.25% per year) while those who became seropositive for V ac A and/or C ag A were 17 of 26 (6.5% per year). Conclusions H . pylori infection is highly dynamic with wide range of spontaneous clearance. It is easily cleared in the first decades of life, more recent years, less crowded homes, and males. It disappears and recurs more often than it was previously thought, implying that the current decline in its prevalence is due to real clearance instead of a fall in infection rate.