Characteristics of Helicobacter pylori infection in Jamaican adults with gastrointestinal symptoms

Helicobacter pylori infection is common in Jamaica. Describing its epidemio logy in a population-based study depends largely on serology, but serologic assays have not been validated in this population, To address this issue, we examined the presence of H. pylori infection in 30 sequential adult pati ents with gastroduodenal symptoms by three biopsy-based methods (rapid urea se test, histology, and culture) as well as by one research and two commerc ial enzyme-linked immunosorbent assays (ELISAs), A patient was considered H . pylori positive if the organism was detected by at least one biopsy-based method. Eighteen (60%) of the 30 patients were H. pylori positive by these criteria, whereas 21 (70%) were seropositive for H. pylori immunoglobulin G by our research ELISA. The presence of H. pylori infection in patients wi th gastric cancer and those with chronic gastritis was missed by biopsy-bas ed methods but was detected by serologic assays, This observation indicates that serologic assays may be better suited for the detection of this infec tion in a population in which H. pylori-associated pathology is prevalent. The performance of our research ELISA in detecting biopsy-based H. pylori-p ositive cases was excellent, with a sensitivity and specificity of 100% and 75%, respectively. Molecular genotyping of the isolates revealed that the predominant H. pylori genotypes in this cohort of Jamaicans were cagA(+) va cA slb-m1, and iceA2, The validated serologic assay enables us to interpret epidemiologic data from population-based studies in Jamaica by comparison to those from other populations.