Niv Yaron
World J Gastroenterol. 2008 Mar 14;14(10):1477-8. doi: 10.3748/wjg.14.1477.
Recurrence of H pylori after eradication is rare in developed countries and more frequent in developing countries. Recrudescence (recolonization of the same strain within 12 mo after eradication) rather than reinfection (colonization with a new strain, more than 12 mo after eradication) is considered to be responsible for most of the cases. This observation was confirmed only in developed countries, while in developing countries a recent meta-analysis demonstrated a high rate of reinfection. The proportion of H pylori annual recurrence was 2.67% and 13.00% in developed and developing countries, respectively. Nested meta-analysis (only cases with a longer follow-up and a negative (13)CUBT a year after eradication) revealed annual recurrence rate of 1.45% [relative risk (RR), 0.54] and 12.00% (RR, 0.92) in developed and developing countries, respectively. These findings support the notion that in developed countries many cases of recurrence are due to recrudescence within the first year after eradication, with a 46% drop in the recurrence rate after the first year post eradication, while in developing countries reinfection is more pronounced, and continue at the same rate since eradication. A different approach for follow-up after H pylori eradication is probably needed in patients of developing countries, since reinfection is highly prevalent.
幽门螺杆菌根除后复发在发达国家较为罕见，而在发展中国家更为常见。复发（根除后12个月内同一菌株再次定植）而非再感染（根除12个月后新菌株定植）被认为是大多数病例的原因。这一观察结果仅在发达国家得到证实，而在发展中国家，最近的一项荟萃分析显示再感染率很高。发达国家和发展中国家幽门螺杆菌的年复发率分别为2.67%和13.00%。巢式荟萃分析（仅包括随访时间较长且根除后一年(13)C尿素呼气试验阴性的病例）显示，发达国家和发展中国家的年复发率分别为1.45%[相对风险(RR)，0.54]和12.00%（RR，0.92）。这些发现支持了这样一种观点，即在发达国家，许多复发病例是由于根除后第一年内的复发，根除后第一年复发率下降46%，而在发展中国家，再感染更为明显，自根除后以来一直以相同的速率持续。由于再感染非常普遍，发展中国家的患者在幽门螺杆菌根除后可能需要采取不同的随访方法。
