Department of Internal medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea.
Helicobacter. 2013 Apr;18(2):135-42. doi: 10.1111/hel.12018. Epub 2012 Oct 8.
The reinfection rate of Helicobacter pylori has been reported to be low in developed countries but high in developing countries. The aim of this study is to evaluate the long-term reinfection rate of H. pylori and to investigate its associated risk factors in South Korea.
During 2003-2010, H. pylori-positive 970 patients received standard proton pump inhibitor (PPI)-based triple eradication therapy, and follow-up H. pylori tests were performed with (13) C urea breath test or invasive tests (Giemsa histology, CLO test, and culture) 4 weeks after completion of treatment. A total of 331 patients who were maintained an H. pylori-eradicated state at 1 year after eradication were divided into two groups according to reinfection. For the evaluation of risk factors of reinfection, gender, age, smoking, alcohol, income, education, gastrointestinal symptoms, clinical diagnosis, histologic atrophic gastritis or intestinal metaplasia, and clarithromycin resistance were analyzed.
The follow-up period was 18-95 months (mean: 37.1 months), and H. pylori reappeared in 36 of 331 patients (10.9%), resulting in the annual reinfection rate of 3.51% per year. Multivariate analysis showed that male gender (HR 2.28; 95% CI, 1.05-5.00, p = .037) and low monthly family income (≤5000$ vs >5000$) (HR 3.54; 95% CI, 1.08-11.67, p = .038) were associated with H. pylori reinfection.
This long-term reinfection rate of H. pylori stayed rather low (3.51% per year), and male and low income determined the reinfection, factors already known to be important for H. pylori infection.
发达国家的幽门螺杆菌再感染率较低，而发展中国家则较高。本研究旨在评估韩国幽门螺杆菌的长期再感染率，并探讨其相关危险因素。
2003 年至 2010 年期间，970 例幽门螺杆菌阳性患者接受了标准质子泵抑制剂（PPI）三联根除治疗，治疗结束后 4 周，通过（13）C 尿素呼气试验或侵袭性试验（吉姆萨组织学、CLO 试验和培养）进行随访幽门螺杆菌检测。在根除治疗 1 年后，将 331 例保持幽门螺杆菌根除状态的患者根据再感染情况分为两组。为了评估再感染的危险因素，分析了性别、年龄、吸烟、饮酒、收入、教育、胃肠道症状、临床诊断、组织学萎缩性胃炎或肠化生以及克拉霉素耐药性。
随访时间为 18-95 个月（平均 37.1 个月），331 例患者中有 36 例（10.9%）出现幽门螺杆菌再感染，年再感染率为 3.51%。多因素分析显示，男性（HR 2.28；95%CI，1.05-5.00，p =.037）和低月家庭收入（≤5000 美元 vs >5000 美元）（HR 3.54；95%CI，1.08-11.67，p =.038）与幽门螺杆菌再感染相关。
本研究幽门螺杆菌的长期再感染率保持在较低水平（3.51%/年），男性和低收入决定了再感染，这些因素已被证明对幽门螺杆菌感染很重要。
