Use of serology, the urease test & histology in diagnosis of Helicobacter pylori infection in symptomatic & asymptomatic Indians

Age-specific prevalence of IgA and IgG antibodies in 714 subjects without g astrointestinal complaints aged 6 months to 90 yr was measured by an enzyme linked immunoassay using an acid-glycine extract of H. pylori as the antig en. The urease test and histology were used for the diagnosis of H. pylori infection in 83 subjects with a clinical diagnosis of dyspepsia, and these results were compared with measurement of IgG, IgA and IgM antibodies. The age specific prevalence of IgG and IBA antibodies respectively was 57 and 4 3 per cent for subjects aged 6 months to 4 yr and showed an increase with a ge to a maximum of 30 per cent for IgG in subjects >60 yr of age and to 87 per cent for IgA in subjects between 51 and 60 yr, In symptomatic patients, there was a high degree of correlation between severity of H. pylori infec tion on histopathological examination and IgG (P<0.02) levels. The use of I gG and IgA estimation could have identified H. pylori infection without end oscopy in 50 of the 83 patients. Serology for IgG and IgA antibodies agains t N. pylori may play a major role in decreasing the need for endoscopy, but cut-off values must be determined for each assay based on the prevalence o f antibodies in the population.