PREVALENCE OF HELICOBACTER-PYLORI INFECTION AND RELATED GASTRODUODENAL LESIONS IN SPOUSES OF HELICOBACTER-PYLORI POSITIVE PATIENTS WITH DUODENAL-ULCER

Background-To date, very few studies have evaluated the risk of infect ion among spouses of Helicobacter pylori positive patients and their r esults are conflicting. Aim-To assess the seroprevalence of H pylori i nfection in spouses of H pylori positive patients with duodenal ulcer as compared with age and sex matched volunteer blood donors, as well a s the frequency of endoscopic gastroduodenal lesions in these spouses, according to the presence or absence of gastrointestinal complaints. Methods-Some 124 spouses (48% males) of patients with duodenal ulcer c onsecutively seen over a 10 month period were studied. They were all s creened for serum IgG anti-H pylori antibodies and asked to complete a questionnaire with particular reference to the presence of chronic or recurrent dyspepsia. Upper gastrointestinal tract endoscopy with antr al and corpus biopsy specimens taken for histological examination and urease rapid test was offered to all seropositive spouses. Volunteer b lood donors (248), living in Milan and matched for age, sex, north-sou th origins, and socioeconomic status to the cases, were used as contro ls. Results-Spouses of patients with duodenal ulcer had a significantl y higher seroprevalence of H pylori infection than controls (71% v 58% , p<0 . 05); 30 of 88 (34%) H pylori positive spouses complained of dy speptic symptoms compared with only four of 34 (12%) seronegative spou ses (p<0 . 02). At endoscopy, H pylori infection was confirmed in 48 o f 49 (98%) seropositive spouses. The endoscopic findings in those spou ses showed active duodenal ulcer in eight (17%), duodenal scar and cap deformity in two (4%), active gastric ulcer in two (4%), erosive duod enitis in three (6%), antral erosions in two (4%), antral erosions plu s duodenitis in one, and peptic oesophagitis in another patient. The p revalence of major endoscopic lesions was significantly higher in symp tomatic spouses than in those who had never been symptomatic. Conclusi ons-These findings show that being the spouse of an H pylori positive patient with duodenal ulcer may increase the risk of H pylori colonisa tion and perhaps of peptic ulcer disease, and raises questions as to w hether serological screening of cohabiting partners of H pylori positi ve patients with duodenal ulcer may be indicated.