Eradikationskontrolle von Helicobacter pylori mittels Stuhltest unter Verwendung monoklonaler Antikörper

Background and Aim: It has been recommended to monitor the success of H. pylori eradication therapy with the 13C-urea breath test (UBT). However, the UBT is expensive and requires the visit of the fasting patient. Stool tests for detection of H. pylori antigen overcome these problems, but the HpSA® based on polyclonal antibodies has a lower accuracy due to lot-to-lot variability. We evaluated a novel monoclonal stool antigen test in adults referred for upper endoscopy to a private practice. Methods: Patients with a rapid urease test (RUT) were recruited if they denied acid suppressive drugs or antibiotics during the last 4 weeks. H. pylori infection was confirmed by either a positive culture and/or positive histology. Prior to and 4-6 weeks after triple therapy UBT and the monoclonal stool antigen test (RIDASCREEN FemtoLab H.pylori, R-Biopharm AG, Germany) were performed. Results: Of 51 H. pylori infected patients (23f, 28m, age 26-79 years) the UBT was positive in 49 and the stool antigen test in 48 (sensitivity: 96% and 94% respectively), while both tests revealed negative results in 3 patients with a positive RUT only. After eradication therapy, there was 100% concordance between UBT and stool test results (40 negative, 10 positive, 1 lost to follow up). Conclusions: In the setting of a private office this monoclonal stool antigen test is as reliable, but less costly (20 vs. 43 Euro) and more convenient than the UBT for detection of H. pylori infection prior to and 4-6 weeks after eradication therapy