RELATION BETWEEN INFECTION WITH HELICOBACTER-PYLORI AND LIVING-CONDITIONS IN CHILDHOOD - EVIDENCE FOR PERSON-TO-PERSON TRANSMISSION IN EARLY-LIFE

Objectives-To relate the prevalence of infection with Helicobacter pyl ori in adults to their living conditions in childhood to identify risk factors for infection. Design-Prevalence study of IgG antibodies to H pylori (> 10 mu g IgG/ml, determined by enzyme linked immunosorbent a ssay (ELISA)) and reported living conditions and other socioeconomic f actors in childhood. Setting-Three factories in Stoke on Trent. Subjec ts-471 male volunteers aged 18 to 65 years. Main outcome measures-Sero prevalence and variables in childhood. Results-Seroprevalence of H pyl ori increased with age (22/74 (29.7%) at < 30 years v 29/46 (63%) at 5 5-65 years; P < 0.001 for trend) and was related to manual occupation (14/65 (21.5%) for non-manual v 162/406 (39.9%) for manual; P = 0.003) . After data were adjusted for age and occupation subjects from large families, whose childhood homes were crowded or who regularly shared a bed in childhood, were significantly more likely to be seropositive ( adjusted odds ratio (95% confidence interval) 2.15 (1.41 to 3.30) for crowding and 2.13 (1.38 to 3.30) for sharing a bed), but there was no relation with possession of a bathroom, inside toilet, refrigerator, o r household pets in childhood. Conclusions-Close person to person cont act in childhood is an important determinant of seroprevalence of H py lori in adulthood, suggesting that the infection is transmitted direct ly from one person to another and may be commonly acquired in early li fe.