Review article: ‘true’ re‐infection of Helicobacter pylori after successful eradication – worldwide annual rates, risk factors and clinical implications

• Published in: Alimentary pharmacology & therapeutics Vol. 29; no. 2; pp. 145 - 160
• Main Authors: ZHANG, Y.‐Y., XIA, H. H.‐X., ZHUANG, Z.‐H., ZHONG, J.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.01.2009; Blackwell
• Subjects: Adult; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; Child; Developed Countries; Developing Countries; Digestive system; Gastroenterology. Liver. Pancreas. Abdomen; Helicobacter Infections - complications; Helicobacter Infections - epidemiology; Helicobacter pylori; Human bacterial diseases; Humans; Infectious diseases; Medical sciences; Pharmacology. Drug treatments; Recurrence; Risk Factors; Time Factors; World; Spirillales; Spirillaceae; Review; Eradication; Epidemiology; Infection; Risk rate; Treatment; Helicobacter pylori; Risk factor; Bacteriosis; Bacteria; Bibliographic review
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2008.03873.x

Summary Background  The incidence of ‘true’ re‐infection with Helicobacter pylori after successful eradication remains uncertain. Aim  To determine the worldwide rates, risk factors and clinical implications of ‘true’ re‐infection of Helicobacter pylori. ‘True’ re‐infection of H. pylori is defined as the situation where tests for H. pylori infection, which were negative for 12 months after eradication, become positive again at a later stage. Results  Thirty six studies were identified through a literature search to be able to produce annual rates of ‘true’ re‐infection, and data from 33 original articles were considered reliable and adequate in the further review. Generally, the reported rates varied from 0% to 23.4% in adults and from 1.9% to 9.6% in children. Most studies from developed countries reported rates of less than 1%, whereas relatively higher rates were reported in most of the developing countries. Small sample sizes included in the studies appeared to be associated with increased re‐infection rates. Interfamilial transmission is the major cause of re‐infection, although iatrogenic re‐infection through contaminated endoscopic equipment has been reported. Conclusion  Helicobacter pylori re‐infection is not a concern in a clinical setting, especially in the developed world; however, caution must be exercised in most developing countries.