REINFECTION VERSUS RECRUDESCENCE IN HELICOBACTER-PYLORI INFECTION

Antimicrobial treatment of Helicobacter pylori is the proper managemen t strategy in patients with ulcers. A high rate of H. pylori reinfecti on after successful eradication therapy however, may give rise to ulce r recurrence. The risk of reinfection, depending on the prevalence and the rate of acquisition of H. pylori infection, varies with socioecon omic status, age and geographical location. The rate of reinfection ma y vary in a similar way. The available data in the literature reveal t hat reinfection by H. pylori is low or absent in developed countries a nd may be lower than the initial rate of acquisition. In addition, rep orted cases of H. pylori reinfection are often cases of recrudescent H . pylori infection. Acquisition rate in developing countries is high, so the reinfection rate is expected to be higher than in developed cou ntries. However, studies discriminating reinfection from recrudescence are lacking and therefore more data from developing regions are neede d to settle if 'cured once, cured forever' holds true.