Accuracy of invasive and noninvasive tests to diagnose Helicobacter pylori infection after antibiotic treatment
Rollán, A.; Giancaspero, R.; Arrese, M.; Figueroa, C.; Vollrath, V.; Schultz, M.; Duarte, I.; Vial, P.
American Journal of Gastroenterology 92(8): 1268-1274
1997
ISSN/ISBN: 0002-9270 PMID: 9260787 Document Number: 469526
Objectives: To compare the diagnostic accuracy of the most widely available tests for diagnosis of Helicobacter pylori infection after antibiotic treatment. Methods: A total of 59 H. pylori-positive, duodenal ulcer patients (mean age, 40.7 +- 11.7 yr; 40 male and 19 female) were treated for 2 wk with either amoxicillin-metronidazole (n = 36) or omeprazole-amoxicillin-tinidazole (n = 23), and after 4 wk, were tested for H. pylori infection by (14C)urea breath test (UBT), serum IgG antibody level, and multiple antral biopsies for rapid urease testing, histology, Warthin-Starry stain, and polymerase chain reaction to detect H. pylori DNA. Infection status was established by a concordance of test results. Results: H. pylori was eradicated in 47 patients (80%). UBT and rapid urease testing had the best sensitivity and specificity, although not statistically different to Warthin-Starry stain and polymerase chain reaction. Serology and histology had little diagnostic value in this setting due to high proportion of false-positive results. Conclusions: Noninvasive UBT is as accurate in predicting H. pylori status after antibiotic treatment as rapid urease testing and Warthin-Starry stain. Especially for duodenal ulcer patients, UBT could be considered the gold standard to confirm eradication of H. pylori.