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BioMed Research International
Volume 2015, Article ID 152823, 6 pages
Research Article

Validation of Urine Test for Detection of Helicobacter pylori Infection in Indonesian Population

1Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Jakarta 10430, Indonesia
2Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu 879-5593, Japan
3Gastroentero-Hepatology Division, Department of Internal Medicine, Airlangga University Faculty of Medicine, Surabaya 60131, Indonesia
4Institute of Tropical Disease, Airlangga University, Surabaya 60115, Indonesia
5Department of Internal Medicine, Santo Antonius Hospital, Pontianak 78115, Indonesia
6Department of Internal Medicine, Yowari Hospital, Jayapura 99352, Indonesia
7Department of Molecular Pathology, Oita University Faculty of Medicine, Yufu 879-5593, Japan
8Department of Gastroenterology and Hepatology, Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA

Received 13 August 2015; Revised 25 November 2015; Accepted 30 November 2015

Academic Editor: Shin-ichi Kosugi

Copyright © 2015 Ari Fahrial Syam et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We measured the accuracy of the urine test (RAPIRUN) for detection of Helicobacter pylori infection in Indonesia (Jakarta, Pontianak, and Jayapura) using histology confirmed by immunohistochemistry and/or culture as gold standards. We also used immunohistochemistry to identify CagA phenotype and analyzed H. pylori CagA diversity in Indonesia. The overall prevalence of H. pylori infection in 88 consecutive dyspeptic patients based on the urine test was 15.9% (14/88), 38.1% for patients in Jayapura that had higher prevalence of H. pylori infection than that in Jakarta (9.7%, ) and Pontianak (8.3%, ). Overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of RAPIRUN were 83.3%, 94.7%, 71.4%, 97.3%, and 93.2%, respectively. All of the H. pylori-positive patients were immunoreactive for anti-CagA antibody but not immunoreactive for East Asian specific anti-CagA antibody in all H. pylori-positive subjects. We confirmed the high accuracy of RAPIRUN in Indonesian population. In general, we found less virulent type of H. pylori in Indonesia, which partly explained the low incidence gastric cancer in Indonesia.