HELICOBACTER-PYLORI REINFECTION IS RARE IN PEPTIC-ULCER PATIENTS CURED BY ANTIMICROBIAL THERAPY

Background: Cure of H. pylori infection in peptic ulcer patients signi ficantly reduces the risk of ulcer recurrence. Since data on the rate of H. pylori reinfection in patients undergoing successful anti-H. pyl ori therapy are sparse, this study was conducted with the aim of deter mining the H. pylori reinfection rate in peptic ulcer patients receivi ng antibacterial treatment to heal their ulcer and cure H. pylori infe ction. Methods: A total of 217 patients with H. pylori-associated duod enal or gastric ulcer were followed up after treatment with various an tibacterial regimens resulting in histologically documented cure of H. pylori infection. Endoscopic and histological examinations were perfo rmed 4 weeks after completion of treatment and after 1, 2 and 5 years, or whenever dyspeptic symptoms occurred. To assess the H. pylori stat us two antral and two corpus biopsies were obtained for histological e xamination. Results: Out of 217 patients with initially cured H. pylor i infection 175 were available for endoscopic follow-up. At the time o f analysis, 44 patients were re-examined after 1 year, 113 patients af ter 2 years and 18 patients after 5 years, giving a total of 360 patie nt years of follow-up. The mean duration of follow-up was 24.7 months. H. pylori reinfection was confirmed histologically in eight patients, three of whom becoming H. pylori-positive again within the first year of follow-up. Six of the eight patients with H. pylori reinfection al so suffered an ulcer relapse. Eight cases of reinfection in 360 patien t years represents an overall reinfection rate of 2.2%. Within the fir st 2 years of follow-up the reinfection rate was 0.8% per year. Conclu sion: Our data suggest that H. pylori reinfection is rare in peptic ul cer patients receiving successful anti-H. pylori therapy. H. pylori re infection frequently coincides with ulcer recurrence. Cure of H. pylor i infection results in cure of peptic ulcer disease, provided H. pylor i reinfection does not occur.