Institute of Gastroenterology and Hepatology, Hanoi, Vietnam.
Internal Medicine Faculty, Hanoi Medical University, Hanoi, Vietnam.
PLoS One. 2021 Nov 24;16(11):e0260454. doi: 10.1371/journal.pone.0260454. eCollection 2021.
Familial transmission can possibly influence the infection and treatment of Helicobacter pylori. This study aimed to describe the prevalence of H. pylori infection and outcomes of eradication treatment among Vietnamese patients who live in the same households.
We conducted a prospective cohort study of Vietnamese household members with upper gastrointestinal complaints. Participants received esophagogastroduodenoscopy and H. pylori testing. The H. pylori-positive patients were treated and asked to return for follow-up within 4 months. To explore factors associated with H. pylori infection at baseline, we performed multilevel logistic regression to account for the clustering effect of living in the same households. To explore factors associated with eradication failure, we used Poisson regression with robust variance estimation to estimate the risk ratio.
The prevalence of H. pylori infection was 83.5% and highest among children <12 years old (92.2%) in 1,272 patients from 482 households. There were variations in H. pylori infection across households (intraclass correlation = 0.14, 95% confidence interval (CI) 0.05, 0.33). Children aged <12 years had higher odds of H. pylori infection (odds ratio = 3.41, 95%CI 2.11, 5.50). At follow-up, H. pylori was eradicated in 264 of 341 patients (77.4%). The risk of eradication failure was lower for the sequential regimen with tetracycline.
H. pylori infection was common among people living in the same households. Eradication success for H. pylori was higher for the tetracycline sequential regimen. More research should be focused on how family factors influence H. pylori infection and on eradication treatment.
家族传播可能会影响幽门螺杆菌的感染和治疗。本研究旨在描述生活在同一家庭的越南患者中幽门螺杆菌感染的流行情况和根除治疗的结果。
我们对有上消化道症状的越南家庭成员进行了前瞻性队列研究。参与者接受了食管胃十二指肠镜检查和幽门螺杆菌检测。幽门螺杆菌阳性患者接受治疗，并要求在 4 个月内进行随访。为了探讨与基线时幽门螺杆菌感染相关的因素，我们采用多水平逻辑回归来解释生活在同一家庭的聚类效应。为了探讨与根除失败相关的因素，我们使用具有稳健方差估计的泊松回归来估计风险比。
在 482 户家庭的 1272 名患者中，幽门螺杆菌感染的患病率为 83.5%，年龄<12 岁的儿童最高（92.2%）。家庭之间的幽门螺杆菌感染存在差异（组内相关系数=0.14，95%置信区间[CI]0.05，0.33）。年龄<12 岁的儿童幽门螺杆菌感染的可能性更高（比值比[OR]=3.41，95%CI 2.11，5.50）。在随访时，341 名患者中有 264 名（77.4%）幽门螺杆菌被根除。四环素序贯方案根除失败的风险较低。
生活在同一家庭的人群中幽门螺杆菌感染很常见。四环素序贯方案对幽门螺杆菌的根除成功率更高。应更多地关注家庭因素如何影响幽门螺杆菌感染和根除治疗。
