Serodiagnosis and seroprevalence of Helicobacter pylori infection in Vietnam

Aims: The aims of the study were to establish and evaluate the best eradication treatment, the optimal diagnostic methods and the impact of Helicobacter pylori infection in Vietnam. Materials: In a treatment trial of patients with peptic ulcer disease (PUD), gastric biopsies and serum samples were obtained from 296 PUD patients (age 18-88 years). H. pylori status was confirmed by culture and/or serology at inclusion, after treatment and after 12 (+/-2) months of follow-up. Serum samples from 91 Swedish patients with gastric ulcer and 158 with duodenal ulcer, H. pylori positives by culture, and 128 asymptomatic Swedish individuals with urea breath test-confirmed H. pylori infection were included. Vietnamese population control sera were obtained from 971 individuals (age 1-88 years) in urban Hanoi and rural Ha Tay. Of these samples, 432 adults (18-88 years) from Hanoi were included in the serological evaluations and all 1971 individuals in the seroep idem io logical study. Methods: The methods used were all in-house ELISA with sonicated Swedish and Vietnamese strains as antigens to measure IgG antibodies after absorption with sonicated Campylobacter jejuni to remove cross-reacting antibodies. The commercial serologic kits investigated were Pyloriset EIA-GIII (Orion Diagnostica, Espoo, Finland), HM-CAP (Enteric Products, Westbury, NY, USA) and HelicoBlot 2.1 (Genelabs, Singapore). Culture of H. pylori was performed by standard methods. The RAPD and the PCR-RFLP used a flaA gene fragment. Results: The standard, twice-daily antibiotics therapy achieved a per protocol H. pylori eradication of 87%, compared to 72% in the once-daily therapy group (p=0.03) and 39% in the antibiotics only group (p