A C-13-urea breath test in children with Helicobacter pylori infection: assessment of eradication therapy and follow-up after treatment

Purpose. Our aim was to evaluate the usefulness of the C-13-urea breath tes t (UBT) for the diagnosis of Helicobacter pylori infection, for assessment of the efficacy of eradication therapy, and for post-treatment follow-up in children. Methods. Seventy-two patients who underwent endoscopy for sympto ms related to the upper gastrointestinal tract were examined by rapid ureas e test, histology, and culture. The patients were also studied with serolog y and UBT. Results. Forty-seven of the 72 patients were diagnosed with H. p ylori infection, based on the results of biopsy-based tests and serology. A s an initial diagnostic test to detect H. pylori infection, the sensitivity of the UBT was 95%, which was comparable with that of histology (94%), rap id urease test (96%), and serology (91%) and was greater than that of cultu re (79%). The specificity of the UBT was 100%, which was comparable with th at of the other four tests. The efficacy of eradication therapy was assesse d by biopsy-based tests and the UBT in 24 H. pylori-positive patients. For this purpose, the sensitivities of UBT and histology were 100%, while the s ensitivities of culture and the rapid urease test were 88%. The specificity was 100% for all of these tests. Eleven patients were assessed by biopsy-b ased tests and UBT after more than 6 months of post-treatment follow-up. Th ere were no discordances between the results of the UBT and those of the bi opsy-based tests in any of the patients. Conclusions. The UBT may be useful for detecting H. pylori infection in children with upper gastrointestinal tract symptoms, for assessment of the efficacy of eradication therapy, and for the follow-up evaluation of patients after the therapy.