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- Title
Eradication rate of Helicobacter pylori in a Mexican population at high risk for gastric cancer and use of serology to assess cure
- Authors
Mohar, Alejandro; Ley, Catherine; Guarner, Jeannette; Herrera-Goepfert, Roberto; Figueroa, Luz-Sánchez; Halperin, David; Parsonnet, Julie
- Abstract
OBJECTIVES:Helicobacter pylori causes gastric adenocarcinoma. We assessed the success of H. pylori eradication therapy in a medically underserved population in Chiapas, Mexico, that is at high risk for gastric cancer risk.METHODS:Healthy volunteers with both antibodies to CagA and gastrin levels ≥25 ng/ml were randomly assigned to receive either a combination of omeprazole, amoxicillin, and clarithromycin or matched placebo for 1 wk. Endoscopy with seven biopsies was performed at baseline, at 6 wk, and 1 yr after treatment. Treatment success was defined as loss of H. pylori by histological analysis. Cure was assessed using change in serology based on the standardized absorbance of a H. pylori ELISA.RESULTS:H. pylori eradication rates were high (intent-to-treat analysis: 76.3% [95% CI = 68.7–84.0%] after 6 wk and 76.1% [95% CI = 67.7–84.6%] after 1 yr; per protocol analysis: 77.8% [95% CI = 70.1–85.4%] after 6 wk and 75.2% [95% CI = 66.5–84.0%] after 1 yr). Nine subjects on active treatment and one subject on placebo who were without H. pylori at 6 wk were infected at 1 yr (recurrence rates 10.7% and 33.3%, respectively, p = 0.31). Median changes in standardized absorbance at 1 yr were 47% and 1% for successfully and unsuccessfully treated patients, respectively. A 10% decline in standardized absorbance after 1 yr had 84% sensitivity and 100% specificity for H. pylori eradication.CONCLUSIONS:Even with a short course of treatment against H. pylori, a high rate of eradication rate can be achieved in populations at high risk for stomach cancer. Serum antibodies are useful in assessing efficacy of therapy.
- Subjects
MEXICO; HELICOBACTER pylori infections; STOMACH cancer risk factors; SEROLOGY
- Publication
American Journal of Gastroenterology (Springer Nature), 2002, Vol 97, Issue 10, p2530
- ISSN
0002-9270
- Publication type
Article
- DOI
10.1111/j.1572-0241.2002.06035.x