HELICOBACTER-PYLORI REINFECTION RATE, IN PATIENTS WITH CURED DUODENAL-ULCER

Objective: To determine the reinfection rate of the gastric mucosa in patients previously cured of duodenal ulcers, following the eradicatio n of Helicobacter pylori. Only those remaining H. pylori-negative beyo nd 12 months of follow-up were studied, to minimize the potential incl usion of patients with H. pylori recrudescence. Methods: Patients with endoscopically proven duodenal ulcers who had been treated with tripl e therapy, resulting in documented eradication of H. pylori and cure o f the ulcer for at least 4 years, were recalled and had their H. pylor i status determined by the C--14 urea breath test. Those found positiv e for H. pylori underwent endoscopic confirmation of the infection. Re sults: Of the 94 patients restudied, with a follow-up period range of 48-96 months or a total of 549.8 yr, only two (2.2%) were again H. pyl ori positive. This gives an effective reinfection rate of 0.36% per pa tient year. In the two H. pylori-positive patients, one had normal muc osa endoscopically, whereas duodenitis without active ulceration was p resent in the other. The former was asymptomatic, whereas the latter p atient was using ranitidine daily for symptom control. Conclusion: In the Australian setting, following cure of duodenal ulcer disease by er adication of H. pylori, subsequent reinfection is an unusual phenomeno n. We conclude that efforts aimed at eradication of H. pylori in duode nal ulcer are justified and are worthwhile.