THE INCIDENCE OF HELICOBACTER PYLORI IN PATIENTS WITH INTERSTITIAL CYSTITIS

Purpose

The cause of interstitial cystitis is unknown. We evaluated the incidence of Helicobacter pylori antibodies in patients with interstitial cystitis to determine whether such infection may be a causative factor.

Materials and Methods

We obtained serum samples from 23 patients with interstitial cystitis and 23 control subjects. Samples were analyzed for the presence of H. pylori IgG antibodies.

Results

The incidence of positive tests for H. pylori antibodies was 22% in the interstitial cystitis group and 35% in controls.

Conclusions

The incidence of infection with H. pylori is not increased in interstitial cystitis, and so it is unlikely to be a causative factor.     

FIVE MICRO-CURIE UREA BREATH TEST FOR THE DIAGNOSIS OF HELICOBACTER PYLORI INFECTION: EVALUATION IN A SOUTH-EAST ASIAN POPULATION

Background : Helicobacter pylori is an important pathogen responsible for significant morbidity and mortality. Its prevalence varies widely in different geographical locations and is especially high in parts of Asia. Methods : A double-blind study was carried out to evaluate the use of the 5 μCi (185 KBq) [14C]-urea breath test ([¹⁴C]-UBT) in a South-East Asian population by validating its diagnostic accuracy against histology and the CLO test. Results : The sensitivity and specificity of the [¹⁴C]-UBT was 100% when compared against the CLO test. When histology was used as the ‘gold standard’, the sensitivity and specificity were 100% and 97.2%, respectively. There was no overlap or indeterminate values between positive and negative results on the [¹⁴C]-UBT. Conclusions : Among South-East Asian populations where the prevalence of H. pylori infection is high, the high sensitivity of the 5 μCi [¹⁴C]-UBT makes it a very important test in the detection of H. pylori.     

PREVALENCE OF HELICOBACTER PYLORI INFECTION IN 160 PATIENTS WITH BARRETT’S OESOPHAGUS OR BARRETT’S ADENOCARCINOMA

Background : The role of Helicobacter pylori infection in the development of Barrett’s oesophagus and its complications is uncertain. The aim of the present study was to determine the importance of H. pylori infection in this disease by comparing the frequency of oesophageal and gastric H. pylori infection in a group of patients with Barrett’s oesophagus or adenocarcinoma, with the frequency of infection in a control group without Barrett’s disease. Methods : The study group included 160 patients (123 male, 37 female; mean age: 61.2 years) who were classified (according to the highest grade pathological lesion in the oesophagus) as having Barrett’s intestinal metaplasia (IM; 88 patients), Barrett’s oesophagus with low‐grade dysplasia (LGD; 28 patients), high‐grade dysplasia (HGD; five patients), Barrett’s indefinite for dysplasia (n = 4), and Barrett’s adenocarcinoma (33 patients). A total of 91 of these patients had gastric antral specimens available for study. The control group consisted of 214 consecutive, prospectively enrolled symptomatic patients (122 male, 92 female; mean age: 57.2 years) who underwent upper gastrointestinal endoscopy and in whom Barrett’s oesophagus or Barrett’s adenocarcinoma was not found. A modified Warthin–Starry method was used to detect H. pylori infection. Results : Oesophageal H. pylori infection was found in eight of 160 (5%) patients with Barrett’s oesophagus or Barrett’s adenocarcinoma. Helicobacter pylori organisms in the oesophagus were found only on non‐intestinalized cardiac or oxyntocardiac mucosa. All patients with oesophageal H. pylori infection and an antral biopsy available for study had antral H. pylori infection. Gastric antral H. pylori infection was significantly less prevalent in patients in the Barrett’s study group (15/91, 16.5%) than in the non‐Barrett’s control group (67/214, 31.3%; Fisher’s exact test, P = 0.01). Patients from the control group with an endoscopic diagnosis of duodenal ulcer, gastric ulcer, gastritis, or duodenitis had a significantly higher prevalence of infection compared with the Barrett’s group, but there was no difference in the infection prevalence in patients in the Barrett’s group and patients with reflux oesophagitis, hiatal hernia, no endoscopic abnormality, or any other diagnosis. Conclusions : Oesophageal H. pylori infection is uncommon in patients with Barrett’s IM, dysplasia, or adenocarcinoma, and may be restricted to non‐intestinalized columnar epithelium. Gastric H. pylori infection may have a protective effect for the development of Barrett’s oesophagus.     

胃癌患者CEA、CA19-9、CA72-4及幽门螺旋杆菌抗体测定及其临床意义

对162例经手术和病理证实的胃癌患者血中的肿瘤标记物CEA、CA19-9、CA72-4及幽门螺旋杆菌(HP)抗体进行了测定，并以90例非肿瘤患者作为对照。结果 胃癌组患者CEA、CA19-9及CA72-4的敏感性分别为24.0%、35.5%和21.9%，特异性分别为93%、77%和100%；阳性预测值(拟然比)分别为85.7%(3.24)、78.6%(1.52)和100%(0)，阴性预测值(拟然比)分别为39.9%(0.28)、33.0%(0.84)和38.9%(0.78)。CA19-9及CA72-4的含量随肿瘤直径的增大而明显增高(P＜0.05)；当肿瘤浸润深度增加时，CA19-9含量也显著增高(P＜0.05)。在淋巴结转移率＞50%或有远处转移的患者，其CEA、CA72-4及CA19-9含量显著增加；在肿瘤分化差的患者，这3种肿瘤标记物的含量均明显高于对照组(P＜0.05)。胃癌患者HP抗体阳性率为54%，对照组为22%(χ     

HELICOBACTER PYLORI, HEPATITIS VIRUSES A, C, E, ANTIBODIES AND HBsAg - PREVALENCE AND ASSOCIATED RISK FACTORS IN PEDIATRIC COMMUNITIES OF KARACHI

Objective: To document the prevalence of Helicobacter pylori (H. pylori), Hepatitis A virus (HAV), Hepatitis C virus (HCV), Hepatitis E virus (HEV) antibodies and Hepatitis B virus surface antigen (HBsAg), in the pediatric age group of low socioeconomic urban communities of Karachi and to identify risk factors associated with these infections. Design: Cross-sectional survey. Place and Duration of Study: Three selected squatter settlements of Karachi during April 2002 to December 2004. Patients and Methods: Three hundred and eighty children, ages 5 months to 15 years were investigated. Venous blood samples were collected and questionnaire filled on sociodemographic characteristics (family income, number of dependents in the family, area of living, number of people per room per house, and number of children sharing bed with parents and siblings). Gastrointestinal symptoms were recorded. Anti-HAV IgG (Hepatitis A virus IgG antibody), anti-HCV (Hepatitis C virus antibody), anti-HEV (Hepatitis E antibodies) and HBsAg, were analyzed by enzyme immunoassays (EIAs). Samples were also screened for anti-HIV1/2 (human immunodeficiency virus 1 and 2 antibodies by EIA. IgG antibodies against H. pylori were detected by immunochromatography. Results: A correlation between increasing age and seroconversion was seen for hepatotropic viruses. At 14 years and above,100% of the children were found to be positive for anti-HAV, 26% for anti-HEV, and 1.4%, for anti-HCV while HBsAg was positive in 1.9%. H. pylori infection did not show a significant increase with age. Both anti-HAV and anti-H. pylori were present simultaneously in 30% of the population investigated. Conclusion: With age, increasing number of children acquired antibodies against hepatotropic viruses and H. pylori. Occurrence of HBsAg and anti-HEV at a later age suggests horizontal, rather than vertical transmission.