Safia Bibi, Waquaruddin Ahmed, Ambreen Arif, Syed Ejaz Alam.
Is raised helicobacter pylori antibody titre enough to decide retreatment?.
Pak J Med Res Jan ;50(3):101-3.

Background: Helicobacter pylori infection causes a rise in its antibodies which take almost a year to come to baseline following successful eradication treatment. Checking these values in between a year may give falsely high values and many patients may thus be over treated. Aims: To serially determine Helicobacter pylori antibody titres in patients after giving them triple therapy for H. pylori eradication and see how these values drop over time. Study type, Settings and duration: Longitudinal study conducted in Department of Gastroenterology and Hepatology, Pakistan Medical Research Council, Research Centre, Jinnah Post Graduate Medical Centre, Karachi, from May 2006 to April 2010. Subjects and Methods: Over the period of four years, 186 patients who were found positive for campylobacter like organism test during endoscopy were further tested for anti H. pylori IgG titre before being treated for H.pylori. Patients were given triple therapy comprising of Omeprazole (20mg twice daily), Amoxicillin (1gm twice daily) and Clarythromycin (500mg twice daily) for a week and were followed at 1, 3, 6 and 12 months to check symptomatic relief and they were tested again for H.Pylori antibody titres. Data was collected on pre-designed proforma which included patient’s demography, symptoms and diagnosis. Results: Out of 186 patients who had a positive campylobacter like organism test, 173 patients consented to participate in the study. Serology for H.Pylori was positive in 119(68%) cases. A decline in mean antibody titres was observed as 11%, 21.5%, 54.7% and 59.2% at 1, 3, 6 and 12 months respectively. Conclusions: Sensitivity of serology for diagnosing H. pylori infection is good but using these as a tool for monitoring response to treatment is doubtful. A slow drop in H.pylori antibodies was seen over 12 months and therefore, physicians are cautioned not to retreat the already treated cases till about one year post treatment. Policy message: H. pylori antibodies should be checked on regular basis to diagnose new cases but it should not be used in previously treated patients to retreat.

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