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Review article: ‘true’ re‐infection of Helicobacter pylori after successful eradication – worldwide annual rates, risk factors and clinical implications
Author(s) -
ZHANG Y.Y.,
XIA H. H.X.,
ZHUANG Z.H.,
ZHONG J.
Publication year - 2009
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2008.03873.x
Subject(s) - medicine , helicobacter pylori , helicobacter pylori infection , transmission (telecommunications) , incidence (geometry) , developed country , helicobacter , intensive care medicine , immunology , environmental health , population , physics , electrical engineering , optics , engineering
Summary Background The incidence of ‘true’ re‐infection with Helicobacter pylori after successful eradication remains uncertain. Aim To determine the worldwide rates, risk factors and clinical implications of ‘true’ re‐infection of Helicobacter pylori . ‘True’ re‐infection of H. pylori is defined as the situation where tests for H. pylori infection, which were negative for 12 months after eradication, become positive again at a later stage. Results Thirty six studies were identified through a literature search to be able to produce annual rates of ‘true’ re‐infection, and data from 33 original articles were considered reliable and adequate in the further review. Generally, the reported rates varied from 0% to 23.4% in adults and from 1.9% to 9.6% in children. Most studies from developed countries reported rates of less than 1%, whereas relatively higher rates were reported in most of the developing countries. Small sample sizes included in the studies appeared to be associated with increased re‐infection rates. Interfamilial transmission is the major cause of re‐infection, although iatrogenic re‐infection through contaminated endoscopic equipment has been reported. Conclusion Helicobacter pylori re‐infection is not a concern in a clinical setting, especially in the developed world; however, caution must be exercised in most developing countries.