Department of Gastroenterology, University of São Paulo Medical School, São Paulo, Brazil.
Helicobacter. 2010 Feb;15(1):46-52. doi: 10.1111/j.1523-5378.2009.00734.x.
The Helicobacter pylori reinfection seems to be higher in developing countries, than in developed ones. The aim of the study was to determine the annual recurrence rate of H. pylori, in Brazilian patients with peptic ulcer disease, in a 5-year follow-up.
Patients, with peptic ulcer disease diagnosed by upper digestive endoscopy (UDE) and H. pylori infection verified by histological analysis, rapid urease test, polymerase chain reaction, and urea breath test (UBT), were treated for bacterial eradication. The cure of the infection was verified using the same tests, 3 months after. Clinical evaluation and UBT were performed after sixth and ninth month. After 1 year of follow-up, UBT and UDE were repeated. Up to the fifth year, patients were assessed twice a year and an UBT was performed annually. The patients included and all the reinfected were tested for 15 different genes of the H. pylori.
One hundred and forty-seven patients were followed: 19 for 1 year, eight for 2 years, four for 3 years, five for 4 years, and 98 for 5 years, totaling 557 patients/years. Recurrence did not occur in the first year. In the second year, two patients were reinfected; in the third, four patients; in the fourth, three patients; and in the fifth, one patient. The total of reinfected patients was 10. The annual reinfection rate was 1.8%.
Brazil presents a low prevalence of H. pylori reinfection, similar to the developed countries.
在发展中国家，幽门螺杆菌的再感染似乎比在发达国家更高。本研究的目的是在 5 年的随访中，确定巴西消化性溃疡患者中幽门螺杆菌的年复发率。
通过上消化道内镜（UDE）诊断患有消化性溃疡病且通过组织学分析、快速尿素酶试验、聚合酶链反应和尿素呼气试验（UBT）证实存在幽门螺杆菌感染的患者，接受了细菌根除治疗。治疗后 3 个月，使用相同的检测方法来验证感染是否已治愈。在第 6 个月和第 9 个月进行临床评估和 UBT。在 1 年的随访后，再次进行 UBT 和 UDE。在第 5 年内，每年进行两次临床评估和一次 UBT。对所有纳入的患者和所有再感染者进行了 15 种不同的幽门螺杆菌基因检测。
共有 147 名患者接受了随访：19 名患者随访 1 年，8 名患者随访 2 年，4 名患者随访 3 年，5 名患者随访 4 年，98 名患者随访 5 年，共 557 名患者/年。第一年未发生复发。第二年有 2 名患者被再感染，第三年有 4 名，第四年有 3 名，第五年有 1 名。共有 10 名再感染患者。年再感染率为 1.8%。
巴西的幽门螺杆菌再感染率较低，与发达国家相似。
