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Helicobacter pylori Recurrence in Patients with Duodenal Ulcer: Clinical, Endoscopic, Histologic, and Genotypic Aspects. A 10‐Year Brazilian Series
Author(s) -
Eisig Jaime N.,
Zaterka Schlioma,
Silva Fernando M.,
Malfertheiner Peter,
Mattar Rejane,
Rodriguez Tomás N.,
Hashimoto Cláudio L.,
Iriya Kioshi,
Laudanna Antonio A.,
MoraesFilho Joaquim P.P.
Publication year - 2006
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/j.1523-5378.2006.00434.x
Subject(s) - rapid urease test , helicobacter pylori , gastroenterology , medicine , asymptomatic , caga , breath test , gastritis , urea breath test , genotype , biopsy , endoscopy , helicobacter pylori infection , virulence , biology , biochemistry , gene
Background: Recurrence infection following successful eradication of Helicobacter pylori is usually low, except for countries with high prevalence of H. pylori. The aim of this study was to verify H. pylori recurrence rate in patients with duodenal ulcer after eradication and the possible relationship with environmental factors, histologic pattern of the mucosa and bacterial genotype. Materials and methods: One‐hundred and ninety‐four patients with an active duodenal ulcer and who were successfully treated for H. pylori infection from 1990 to 1999 were studied. A questionnaire was answered about their living conditions, and a 14 C‐urea breath test was performed. Patients with a positive breath test underwent an upper endoscopy to investigate for possible ulcer recurrence; gastric biopsy samples were than collected for rapid urease test and for histologic assessment. H. pylori vac A and cag A genotype was determined by polymerase chain reaction in those samples with positive urease test. Results: H. pylori infection was detected in 11 patients (recurrence rate of 5.7%) that were not associated with the type of bacterial virulence. In 10 patients the ulcer was healed and all of them were clinically asymptomatic. In eight, histology showed an intensification of gastritis. All 11 patients had adequate housing and sanitary conditions and no other risk for H. pylori recurrence was identified. Conclusions: The recurrence rate of H. pylori in Brazil was higher than that reported in developed countries, but lower than usually reported in developing ones. Ulcer relapse rarely occurs even in long‐term follow up.