SEROPREVALENCE OF HEPATITIS-A VIRUS AND HELICOBACTER-PYLORI INFECTIONS IN THE GENERAL-POPULATION OF A DEVELOPED EUROPEAN COUNTRY (THE SAN-MARINO STUDY) - EVIDENCE FOR SIMILAR PATTERN OF SPREAD

Objective: To evaluate the role of faecal-oral transmission in the spr ead of Helicobacter pylori. Design: A cross-sectional comparison of th e patterns of hepatitis A and H. pylori seropositivity. Methods: At in terview, blood samples and questionnaire data were collected from a ra ndom sample of 1528 healthy subjects aged 20-85 years from the Republi c of San Marino. Serum samples from each subject were then tested for anti-H. pylori and anti-hepatitis A antibodies. Results: Overall, 529 of 670 H. pylori-seropositive subjects (78.9%) and 460 of 858 H. pylor i-seronegative subjects (53.6%) were hepatitis A seropositive (P < 0.0 1; odds ratio = 3.2; confidence interval 95% = 2.6-4.1). This associat ion remained after adjustment by a multiple logistic regression analys is for the confounding effect of age and length of schooling, as surro gate for socio-economic status (OR = 2.0; CI 95% = 1.3-3.3). The age-s pecific prevalence curves for H. pylori and hepatitis A infections sho wed a parallel increase by age, although to a lesser extent for H. pyl ori. Conclusion: These findings provide evidence that in the community studied H. pylori may have spread in a manner similar to that of hepa titis A.