CLINICAL-SIGNIFICANCE OF HELICOBACTER-PYLORI SEROPOSITIVITY AND SERONEGATIVITY IN ASYMPTOMATIC BLOOD-DONORS

To determine the clinical significance of Helicobacter pylori seroposi tivity and seronegativity in healthy blood donors, we carried out a se rological evaluation of Helicobacter pylori status and endoscopy in a healthy blood donors population In all, 1010 donors were screened for Helicobacter pylori by IgG ELISA and assessed for pepsinogen I and gas trin levels by RIA; 298 IgG seropositive and 61 seronegative subjects underwent endoscopy with biopsies. Of 359, 165 were also tested for Ca gA by western blotting. Of the 298 IgG seropositives, 274 were shown t o be infected on biopsy testing. Endoscopy revealed 70 peptic ulcers, 41 cases of erosive duodenitis, and two gastric cancers. In all 105 se ropositive donors were tested for CagA and 69 were CagA positive [34/5 8 gastritis (58.6%), 24/35 duodenal ulcer (68.6%) and 11/12,gastric ul cer (91.6%)]. Histologically active/chronic gastritis was associated w ith CagA: 88.4% vs 50% (CagA seropositive vs seronegative). Of the 61 IgG seronegatives, 59 were negative on biopsy testing. At endoscopy th ree had duodenitis. Of the 60/61 IgG seronegatives tested for CagA, on e had a moderate reaction. Duodenal ulcer donors showed higher pepsino gen I levels than donors without duodenal ulcers (97.7 mu g/ml vs 80.9 mu g/ml respectively). Screening for Helicobacter pylori and anti-Cag A seropositivity and pepsinogen I can identify individuals likely to h ave gastroduodenal pathology even in the absence of symptoms.