Prevalence of Helicobacter pylori infection detected by serology and C-13-urea breath test in HIV-1 perinatally infected children

Background: Conflicting results have been reported in adults with human imm unodeficiency virus (HIV-1) who were investigated for Helicobacter pylori i nfection. Most studies indicate a lower prevalence than is found in the gen eral population. The purposes of this study were to evaluate H, pylori prev alence by noninvasive methods in a population of children perinatally infec ted with HIV-1 and to correlate H. pylori prevalence with HIV-1-related cli nical and immunologic status. Methods: H. pylori infection was studied in 45 children perinatally infecte d with HIV-1 by performing serologic testing of anti-H. pylori immunoglobul in G antibodies and the C-13-urea breath test. Results: Eight children with HIV-1 (17.7%) were positive by serology, and n ine (20%) were positive by C-13-urea breath test. No significant difference s related to age, previous antibiotic treatment, immunoglobulin administrat ion, antiretroviral treat-ment, abdominal pain, CD4+ cell count, number of HIV-1 RNA copies, and frequency of severe immunodepression were noted betwe en children with positive C-13-urea breath test results and those with nega tive results. Children with positive results were significantly more likely to have severe clinical manifestations. Conclusions: The results show, by both serology and C-13-urea breath test, a prevalence of H. pylori infection comparable with the prevalence in the n ormal population of the same age. H. pylori prevalence has probably been un derestimated in patients with HIV. Results of serologic and histologic anal yses for H. pylori require cautious interpretation, especially in severely immunodeficient patients.