Relation between infection with Helicobacter pylori and living conditions in childhood: evidence for person to person transmission in early life.

OBJECTIVES

To relate the prevalence of infection with Helicobacter pylori in adults to their living conditions in childhood to identify risk factors for infection.

DESIGN

Prevalence study of IgG antibodies to H pylori (> 10 micrograms IgG/ml, determined by enzyme linked immunosorbent assay (ELISA)) and reported living conditions and other socioeconomic factors in childhood.

SETTING

Three factories in Stoke on Trent.

SUBJECTS

471 male volunteers aged 18 to 65 years.

MAIN OUTCOME MEASURES

Seroprevalence and variables in childhood.

RESULTS

Seroprevalence of H pylori increased with age (22/74 (29.7%) at < 30 years v 29/46 (63%) at 55-65 years; P < 0.001 for trend) and was related to manual occupation (14/65 (21.5%) for non-manual v 162/406 (39.9%) for manual; P = 0.003). After data were adjusted for age and occupation subjects from large families, whose childhood homes were crowded or who regularly shared a bed in childhood, were significantly more likely to be seropositive (adjusted odds ratio (95% confidence interval) 2.15 (1.41 to 3.30) for crowding and 2.13 (1.38 to 3.30) for sharing a bed), but there was no relation with possession of a bathroom, inside toilet, refrigerator, or household pets in childhood.

CONCLUSIONS

Close person to person contact in childhood is an important determinant of seroprevalence of H pylori in adulthood, suggesting that the infection is transmitted directly from one person to another and may be commonly acquired in early life.