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Evidence summaries

Recurrence of Helicobacter Pylori Infection after Successful Eradication

Recrudescence of Helicobacter pylori after successful eradication may most often occur during the first 12 months, usually with the same strain. Level of evidence: "C"

A systematic review 1 including 32 studies with a total of 1 868 subjects was abstracted in DARE. Overall recurrence rates ranged from 0% to 40% at six months post treatment, from 0% to 41.5% at 12 months post treatment, and from 2.2% to 9.3% at 48 months post treatment. Regression analysis showed that the recurrence rate is about 5% when the eradication rate is 90%. Recurrence rate appears to be highest in the first 12 months after treatment completion. Four studies with genetical mapping (n=17) found that the majority of recurrences were with the identical organism. The one study that reported the Helicobacter strain in the spouse found the same strain, which means it is not possible to differentiate between recrudescence and reinfection. Sampling only in the antrum may lead to false negative Helicobacter findings after eradication.

References

  • Xia HX, Talley NJ, Keane CT, O'Morain CA. Recurrence of Helicobacter pylori infection after successful eradication: nature and possible causes. Dig Dis Sci 1997 Sep;42(9):1821-34. [PubMed][DARE]

Primary/Secondary Keywords