Diagnostic accuracy of tests for Helicobacter pylori in an Alaska Native population.

Abstract:

AIM:To evaluate the accuracy of two non-invasive tests in a population of Alaska Native persons. High rates of Helicobacter pylori (H. pylori) infection, H. pylori treatment failure, and gastric cancer in this population necessitate documentation of infection status at multiple time points over a patient's life. METHODS:In 280 patients undergoing endoscopy, H. pylori was diagnosed by culture, histology, rapid urease test, (13)C urea breath test (UBT), and immunoglobulin G antibodies to H. pylori in serum. The performances of (13)C-UBT and antibody test were compared to a gold standard defined by a positive H. pylori test by culture or, in case of a negative culture result, by positive histology and a positive rapid urease test. RESULTS:The sensitivity and specificity of the (13)C-UBT were 93% and 88%, respectively, relative to the gold standard. The antibody test had an equivalent sensitivity of 93% with a reduced specificity of 68%. The false positive results for the antibody test were associated with previous treatment for an H. pylori infection [relative risk (RR) = 2.8]. High levels of antibodies to H. pylori were associated with chronic gastritis and male gender, while high scores in the (13)C-UBT test were associated with older age and with the H. pylori bacteria load on histological examination (RR = 4.4). CONCLUSION:The (13)C-UBT outperformed the antibody test for H. pylori and could be used when a non-invasive test is clinically necessary to document treatment outcome or when monitoring for reinfection.

journal_name

World J Gastroenterol

authors

Bruden DL,Bruce MG,Miernyk KM,Morris J,Hurlburt D,Hennessy TW,Peters H,Sacco F,Parkinson AJ,McMahon BJ

doi

10.3748/wjg.v17.i42.4682

subject

Has Abstract

pub_date

2011-11-14 00:00:00

pages

4682-8

issue

42

eissn

1007-9327

issn

2219-2840

journal_volume

17

pub_type

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