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Review: Diagnosis of Helicobacter pylori infection
Author(s) -
Makristathis Athanasios,
Hirschl Alexander M.,
Mégraud Francis,
Bessède Emilie
Publication year - 2019
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.12641
Subject(s) - helicobacter pylori , serology , medicine , urea breath test , chronic gastritis , gastroenterology , gastritis , breath test , antigen , monoclonal antibody , clarithromycin , stain , antibody , pathology , helicobacter pylori infection , staining , immunology
Endoscopic imaging of the stomach is improving. In addition to narrow band imaging, other methods, for example, blue light imaging and linked color imaging, are now available and can be combined with artificial intelligence systems to obtain information on the gastric mucosa and detect early gastric cancer. Immunohistochemistry is only recommended as an ancillary stain in case of chronic active gastritis without Helicobacter pylori detection by standard staining, and recommendations to exclude false negative H. pylori results have been made. Molecular methods using real‐time PCR , droplet digital PCR , or amplification refractory mutation system PCR have shown a high accuracy, both for detecting H. pylori and for clarithromycin susceptibility testing, and can now be used in clinical practice for targeted therapy. The most reliable non‐invasive test remains the 13 C‐urea breath test. Large data sets show that DOB values are higher in women and that the cut‐off for positivity could be decreased to 2.74 DOB . Stool antigen tests using monoclonal antibodies are widely used and may be a good alternative to UBT , particularly in countries with a high prevalence of H. pylori infection. Attempts to improve serology by looking at specific immunodominant antigens to distinguish current and past infection have been made. The interest of Gastropanel ® which also tests pepsinogen levels was confirmed.