PREVALENCE OF SERUM ANTIBODIES TO HELICOBACTER-PYLORI AND TO CAGA PROTEIN IN LIVER-TRANSPLANT RECIPIENTS

Objective: To study Helicobacter pylori seroepidemiology before and af ter orthotopic liver transplantation. Methods: Serum samples obtained from 118 liver transplant recipients before and after transplantation were examined for the presence of IgG antibodies to H. pylori whole ce ll extract and to the CagA protein of H. pylori. Results: Of 118 patie nts, 64 (54.2%) were H. pylori positive, and 36 (56.3%) of these had C agA antibodies. Of the 64 seropositive patients, 22 (34.4%) remained p ositive and 42 (65.6%) became negative for H. pylori antibodies a medi an of 39 months after transplantation. Patients who seroreverted showe d a tendency to lower pretransplantation antibody levels and had recei ved antibiotic therapy for at least 4 days. Seroreversion or antibody persistence was not affected by age, sex, CagA antibody status, CagA a ntibody titer, duration of antibiotic therapy, or immunosuppressive dr ugs administered after liver transplantation. Conclusions: The prevale nce of H. pylori infection, as detected by serological screening, in p atients selected for liver transplantation is not different from that in the general population. In these patients, the seroprevalence of H. pylori drops after liver transplantation. This is largely due to the intake of antibiotics and immunosuppressants by transplant recipients. Seroreversion seems to be independent of the type of H. pylori bacter ia.