Observation of Changes in Helicobacter pylori Antigen and Antibody Positivity According to Non-Invasive Tests Before and After Helicobacter pylori Eradication Therapy in Symptomatic Patients

Anandita Zaman,¹ SM Shamsuzzaman,¹ Farshid Bhuiyan,² Md Riasat Hasan,³ Takashi Saito<sup>3

1</sup>Dhaka Medical College, Department of Microbiology, Dhaka, Bangladesh; ²Holy Family Red Crescent Medical College, Department of Physiology, Dhaka, Bangladesh; ³Division of Clinical Cariology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan

Correspondence: Md Riasat Hasan
Division of Clinical Cariology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
Tel +81-133-23-1129
Fax +81-133-23-1296
Email riasat@hoku-iryo-u.ac.jp

Background: Non-invasive tests can help with the diagnosis of Helicobacter pylori (H. pylori) infection and in determining patient prognosis following H. pylori eradication therapy. The aim of the study was to detect H. pylori antigens in the stool in symptomatic patients and to observe changes in the antigen test results following H. pylori eradication therapy.
Methods: A prospective study was conducted. Blood, urine and stool samples were collected from 62 dyspeptic patients. Anti-H. pylori IgM and IgG antibodies were detected in the serum by ELISA, anti-H. pylori IgG antibodies were detected in the urine by ICT and H. pylori antigens were detected in the stool by ELISA. Among the 62 patients, 39 (62.90%) were positive with all three methods. These 39 patients were asked to complete a 2-week course of medication and return after 6 weeks following completion of therapy to undergo repeated tests. In total, 3 dropped out of the study.
Results: Among the 62 dyspeptic patients, 41 (66.13%) were positive for serum IgG according to ELISA, 39 (62.90%) were positive for urine IgG according to ICT, 8 (12.90%) were positive for serum IgM according to ELISA, and 42 (67.74%) were positive for HpSA according to ELISA. After eradication therapy, 18 (50.00%) patients were positive for serum IgG, 19 (52.78%) were positive for urine IgG, 4 (11.11%) were positive for serum IgM and 5 (13.88%) were positive for HpSA. The difference in HpSA positivity before and after eradication therapy was statistically significant (P < 0.05).
Conclusion: This study involved non-invasive procedures that can be used as first-line screening tools for the detection of active H. pylori infection to observe the role of HpSA test in diagnosis and assessment of prognosis following eradication therapy for H. pylori.

Keywords: H. pylori, RAPIRUN, ELISA, prognosis, HpSA