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Canadian Journal of Gastroenterology
Volume 12, Issue 2, Pages 117-124
Original Article

Utility of Serology in Determining Helicobacter pylori Eradication after Therapy

Carlo A Fallone,1 Vivian G Loo,2 and Alan N Barkun2

1Division of Gastroenterology and Department of Microbiology, Royal Victoria Hospital, Canada
2Division of Epidemiology and Biostatistics and Division of Gastroenterology, Montreal General Hospital, McGill University, Montreal, Quebec, Canada

Received 22 October 1997; Accepted 9 January 1998

Copyright © 1998 Hindawi Publishing Corporation. 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.


OBJECTIVE: To determine the usefulness of four serological tests in confirming cure of H pylori infection before the previously reported six-month post-treatment delay.

PATIENTS AND METHODS: As part of a prospective, blinded, controlled trial, in which patients with duodenal ulcers were randomized to receive different combinations of antibiotics, serum samples were obtained in 89 patients before treatment, as well as on several occasions after treatment. Antibody titres were determined by ELISA with Bio-Rad immunoglobulin (Ig) A, Bio-Rad IgG, Pyloriset EIA-A for IgA and Pyloriset EIA-G for IgG. Eradication was confirmed with antral biopsy three months after therapy.

RESULTS: The percentage drop in titre following treatment was significantly larger for the group of patients who were treated successfully with all four kits. Optimal cut-offs for identifying successful therapy were determined, and accuracy improved as the interval between testing and therapy was prolonged. Six months after therapy, the IgG test from Bio-Rad achieved 100% sensitivity and 80% specificity, and that from Pyloriset achieved 88% sensitivity and 100% specificity. At three months, however, test performance was quite good, with 90% sensitivity and 80% specificity when using a Pyloriset IgA titre drop of 20% or greater to predict successful eradication.

CONCLUSION: Serology is a simple, easily available, noninvasive method that exhibits good positive predictive value in the confirmation of successful cure ofH pylori infection three or six months after treatment.