SEROLOGY AS A VALID SCREENING-TEST FOR HELICOBACTER-PYLORI INFECTION IN ASYMPTOMATIC SUBJECTS

Serologic testing is generally accepted as a valid noninvasive screeni ng method for the detection of a Helicobacter pylori infection. To val idate serology as an appropriate screening test for H pylori infection in symptom-free subjects, a recent-generation enzyme-linked Immunosor bent assay for the detection of H pylori-specific IgG was performed in a large series of asymptomatic women. Blood samples for H pylori sero logy were taken from 542 apparently healthy women (aged 20 to 40 years ) during prenatal screening. In this group, 120 (22.1%) had a positive titer for H pylori. We observed a significantly higher overall preval ence of H pylori seropositivity in nonwhites (62.3%) when compared wit h Belgian-born whites (17.8%). In both groups there was a significant increase in seropositivity with increasing age. To investigate the cor relation between a positive enzyme-linked immunosorbent assay and the actual presence of an active H pylori infection, carbon 13-labeled ure a breath tests were performed in 85 seropositive and in 65 randomly se lected seronegative subjects. These breath tests were positive in 82 ( 96.5%) of 85 seropositive and in none of the seronegative subjects, re flecting an actual presence of H pylori in the gastric mucosa of the s eropositive women. We conclude that in our population of H pylori-sero positive subjects positive serologic findings correlates extremely wel l with an active infection with this bacterium. However, because all s ubjects who were investigated were actually symptom-free, it still sho uld be determined whether these patients should undergo upper gastroin testinal endoscopy and/or be treated with an eradication therapy again st H pylori. Further long-term follow-up studies will be required to a nswer this question.