Recurrence of Helicobacter pylori Infection after Eradication: Incidence and Variables Influencing It

Abstract

Background: Our aim was to study the incidence of Helicobacter pylori recurrence in our country and to assess the different variables that might influence it. Methods: We studied prospectively 331 duodenal ulcer patients (mean age, 48_14 years, 71% male) in whom H. pylori had been eradicated. Several therapies were used, classified as low-efficacy (omeprazoleamoxycillin, 32% eradication rate; omeprazole_amoxycillin_metronidazole, 56%) and high-efficacy therapies (omeprazole_clarithromycin_ amoxycillin or metronidazole, 88%; bismuth triple therapy, 77%). One month after completion of therapy an endoscopy with biopsies and/or ¹³C-urea breath test was performed. A breath test was carried out again at 6 months, 1 year, and 2 years, to study H. pylori recurrences. Endoscopy (with biopsies) was performed only to confirm recurrences. Multiple logistic regression analysis was used. Differences between Kaplan-Meier curves were evaluated with the log-rank test. Results: Sixty-seven patients were followed up for 6 months, 136 for 1 year, and 128 for 2 years, giving 425 patient-years of follow-up. A total of 18 H. pylori recurrences was observed (12 at 6 months, 4 at 1 year, and 2 after 2 years), yielding a yearly recurrence of 4.2% patient-years^-1. The respective risk of H. pylori recurrence for each period was 3.6% (95% confidence interval (CI), 2.1%-6.2%), 1.5% (0.6%-3.8%), and 1.5% (0.4%-5.5%). The probability of being H. pylori-negative