COMPARISON OF BIOPSY AND SEROLOGICAL METHODS OF DIAGNOSIS OF HELICOBACTER-PYLORI INFECTION AND THE POTENTIAL ROLE OF ANTIBIOTICS

Objective: Endoscopic biopsy and serological methods were compared for their ability to detect Helicobacter pylori infection in patients und ergoing upper gastrointestinal endoscopy at a state university hospita l. Methods: Subjects mere characterized on the basis of gastrointestin al symptoms, endoscopic findings, socioeconomic and demographic featur es, and the use of certain medications, tobacco, and alcohol. Current infection was detected in gastric antral specimens by rapid urease tes ting, histopathology, and bacterial culture, Serum levels of IgG to H. pylori were measured by ELISA, Results: Of 240 subjects, 115 (47.9%) were currently infected as determined by rapid urease testing, histopa thology, and/or culture results, whereas 63.3% had elevated anti-H, py lori IgG levels (p < 0.001). This difference in the prevalence of curr ent infection and seropositivity was preserved when the study populati on was analyzed according to age, race, gender, and other characterist ics. Prior use of antibiotics was associated with a significant reduct ion in the frequency of H, pylori infection, Conclusions: Serological evidence of H, pylori infection was consistently greater than the prev alence of infection documented by biopsy methods in this study, sugges ting suppression or recent clearance of infection. Further studies are needed to examine the factors that may affect the detection of H, pyl ori infection. (Am J Gastroenterol 1998;93:1291-1296. (C) 1998 by Am. Coll. of Gastroenterology).