HELICOBACTER-PYLORI REINFECTION RATES IN CHILDREN AFTER ERADICATION THERAPY

Background: There are few studies of Helicobacter pylori reinfection i n childhood. In the current study the reinfection rate of H. pylori an d ulcer recurrence were investigated during a follow-up period of 12 m onths or more in children who had undergone eradication therapy. Metho ds: Twenty-seven patients aged 5 to 16 years (6 with gastric ulcer, 13 with duodenal ulcer, and 8 with nodular gastritis) were studied. Biop sy-based H. pylori tests performed 1 to 2 months after eradication the rapy demonstrated that eradication was successful in 23 patients (5 wi th gastric ulcer, 11 with duodenal ulcer, and 7 with nodular gastritis ) and unsuccessful in 4 (1 with gastric ulcer, 2 with duodenal ulcer, and 1 with nodular gastritis). Twenty-three successfully treated patie nts were observed for a mean of 22 months (a total of 42.2 patient yea rs of follow-up). To assess H. pylori status, all 23 patients underwen t a C-13-urea breath test 1 year after eradication therapy. If thee te st result was negative, the patients underwent the follow-up test once every year thereafter. In successfully and unsuccessfully treated pat ients, endoscopy was performed if a patient reported symptoms suggesti ng ulcer recurrence. Results: The initial follow-up C-13-urea breath t ests showed that all 23 patients remained free of infection at 12 to 1 9 months. Among 17 patients, the second test confirmed reinfection in 1 at 28 months. In two patients studied, the third test showed a negat ive result. The reinfection rate was 2.4% per patient year. Over the f ollow-up period, ulcer recurrence was found in 2 of 3 ulcer patients w ith eradication failure but in none of the 16 ulcer patients with succ essful eradication. The recurrence rate was significantly lower in suc cessfully treated patients than in unsuccessfully treated patients (p < 0.05). Conclusions: Reinfection with H. pylori is rare in children a ged more than years, and successful eradication significantly reduces ulcer recurrence. This study supports the benefit of eradication thera py in older children.