Dino Vaira, MD; Nimish Vakil, MD; Marcello Menegatti, MD; Ben van't Hoff, MD; Chiara Ricci, MD; Luigi Gatta, MD; Giovanni Gasbarrini, MD; Mario Quina, MD; Jose M. Pajares Garcia; Arie van der Ende, MD; Rene van der Hulst, MD; Marcello Anti, MD; Cristina Duarte, MD; Javier P. Gisbert, MD; Mario Miglioli, MD; Guido Tytgat, MD
Grant Support: Stool testing kits were provided by Meridian Diagnostics, Inc.
Requests for Single Reprints: Dino Vaira, MD, Department of Internal Medicine and Gastroenterology, S. Orsola Hospital, via Massarenti 9, 40138 Bologna, Italy; e-mail, vairadin@med.unibo.it.
Current Author Addresses: Drs. Vaira, Menegatti, Ricci, Gatta, and Miglioli: Department of Internal Medicine and Gastroenterology, S. Orsola Hospital, via Massarenti 9, 40138 Bologna, Italy.
Dr. Vakil: University of Wisconsin Medical School, Sinai Samaritan Medical School, 945 North 12th Street, Room 4040, Milwaukee, WI 53233.
Drs. van't Hoff, van der Ende, van der Hulst, and Tytgat: Academisch Ziekenhuis bij de Universiteit van Amsterdam, Academisch Medisch Centrum, Amsterdam, the Netherlands 1100DE.
Drs. Gasbarrini and Anti: Policlinico Gemelli, via Pineta Sacchetti, 00168 Rome, Italy.
Drs. Quina and Duarte: Servico Universitario de Medicina Interna e Gastroenterologia, Hospital de Pulido Valente, Alameda das Linhas de Torres 117, P-1750 Lisboa, Portugal.
Dr. Pajares Garcia and Gisbert: Hospitales Universitarios, La Princesa-Niño Jesus-Santa Cristina, Diego de Leon, 62, 28006 Madrid, Spain.
Author Contributions: Conception and design: D. Vaira, N. Vakil, M. Menegatti, B. van't Hoff, C. Ricci, L. Gatta, G. Gasbarrini, M. Quina, J. Pajares Garcia, A. van der Ende, R. van der Hulst, M. Anti, C. Duarte, J.P. Gisbert, M. Miglioli, G. Tytgat.
Analysis and interpretation of the data: D. Vaira, N. Vakil, M. Menegatti, B. van't Hoff, C. Ricci, L. Gatta, A. van der Ende, R. van der Hulst, C. Duarte, J.P. Gisbert, G. Tytgat.
Drafting of the article: D. Vaira, N. Vakil, M. Menegatti, B. van't Hoff, C. Ricci, L. Gatta, A. van der Ende, R. van der Hulst, C. Duarte, J.P. Gisbert, G. Tytgat.
Critical revision of the article for important intellectual content: D. Vaira, N. Vakil, M. Menegatti, C. Ricci, L. Gatta, G. Gasbarrini, M. Quina, J. Pajares Garcia, R. van der Hulst, M. Anti, C. Duarte, M. Miglioli, G. Tytgat.
Final approval of the article: D. Vaira, N. Vakil, M. Menegatti, B. van't Hoff, C. Ricci, L. Gatta, G. Gasbarrini, J. Pajares Garcia, A. van der Ende, R. van der Hulst, M. Anti, C. Duarte, J.P. Gisbert, G. Tytgat.
Provision of study materials or patients: D. Vaira, B. van't Hoff, M. Miglioli.
Statistical expertise: N. Vakil.
Collection and assembly of data: D. Vaira, N. Vakil, B. van't Hoff, C. Ricci, L. Gatta, C. Duarte, J.P. Gisbert.
Current noninvasive tests to confirm the eradication of Helicobacter pylori must be performed 4 weeks or more after eradication therapy is completed.
To determine whether the stool antigen test, a relatively new noninvasive test for H. pylori, administered at various times after eradication therapy correctly identifies persons with persistent H. pylori infection.
Prospective blinded study.
Six clinical centers in the United States and Europe.
84 H. pylori–infected patients undergoing endoscopy for upper abdominal symptoms.
At baseline and on day 35 after the completion of triple eradication therapy, all patients underwent endoscopy with histologic examination, rapid urease test and culture, urea breath test, and a stool antigen test. The stool antigen test was also performed on days 3, 7, 15, 21, 28, and 35 after completion of therapy.
Compared with the gold-standard endoscopic tests on day 35 after antimicrobial therapy, the urea breath test had a sensitivity of 94% (95% CI, 71% to 100%) and a specificity of 100% (CI, 94% to 100%). The stool antigen test had a sensitivity of 94% (CI, 71% to 100%) and a specificity of 97% (CI, 89% to 100%). On day 7 after treatment, the stool antigen test was predictive of eradication (positive predictive value, 100% [CI, 69% to 100%]; negative predictive value, 91% [CI, 82% to 97%]).
A positive result on the stool antigen test 7 days after completion of therapy identifies patients in whom eradication of H. pylori was unsuccessful.
Vaira D, Vakil N, Menegatti M, et al. The Stool Antigen Test for Detection of Helicobacter pylori after Eradication Therapy. Ann Intern Med. 2002;136:280–287. doi: 10.7326/0003-4819-136-4-200202190-00007
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© 2019
Published: Ann Intern Med. 2002;136(4):280-287.
DOI: 10.7326/0003-4819-136-4-200202190-00007
Gastroenterology/Hepatology, H. Pylori, Infectious Disease, Peptic Disease.
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