Helicobacter pylori Stool Antigen Test: a reliable non-invasive test for the diagnosis of Helicobacter pylori infection in children

Objective To evaluate the Helicobacter pylori Stool Antigen (HpSA) test for the diagnosis of H. pylori infection in children. Design and setting Prospective cohort study in an academic medical centre. Patients and methods A total of 106 consecutive children who underwent gast roscopy were included. Biopsy specimens were sampled from the gastric antru m and corpus for the assessment of H. pylori infection by culture and histo logy. A patient was defined to be H. pylori positive if the results of cult ure and/or histology proved to be H. pylori positive; a patient was defined to be negative if both test results were negative. All children provided a stool sample within 2 days of gastroscopy. H. pylori antigens in faeces we re assessed by an enzyme immunoassay (Premier HpSA (R), Meridian Diagnostic s, Inc., Cincinnati, OH, USA). Results The mean age of included patients was 8.5 years (range 1 -18.5). Th irty patients were H. pylori positive and 76 patients were H. pylori negati ve. Using the recommended cut-off values of 0.140 optical density (OD) and 0.159 OD, sensitivity and specificity of 100% and 92% were found. The posit ive and negative predicting values were 83% (30/36) and 100% (70/70), respe ctively. Conclusion The HpSA test is an accurate test for the diagnosis of H. pylori infection in children, and might therefore be a good alternative for diagn ostic tests such as the C-13-urea breath test (UBT). (C) 2001 Lippincott Wi lliams & Wilkins.