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Updated: Aug 30, 2026
Quantitative Polymerase Chain Reaction (qPCR)-Based Rapid Diagnosis of Helicobacter pylori Infection and Antibiotic Resistance
Published on: July 28, 2023
Helicobacter pylori diagnosis in patients with liver cirrhosis
L Sanchez-Mete1, A Zullo, C Hassan
1Department of Clinical Medicine-Gastroenterology, La Sapienza University, Rome, Italy.
Insights
The [13C]urea breath test accurately detects Helicobacter pylori in cirrhotics. Other methods like serology and rapid urease tests yield less reliable results in this patient group.
Area of Science:
- Gastroenterology
- Hepatology
- Infectious Diseases
Background:
- Helicobacter pylori infection is a primary cause of peptic lesions and upper gastrointestinal bleeding in patients with liver cirrhosis.
- Accurate detection of H. pylori is crucial but challenging in cirrhotic patients due to limitations of certain diagnostic methods.
Purpose of the Study:
- To evaluate the diagnostic accuracy of various H. pylori detection methods in cirrhotic patients.
- To compare these methods in patients with and without gastroduodenal lesions.
Main Methods:
- The study included 53 cirrhotic patients undergoing upper endoscopy with biopsies.
- H. pylori detection utilized Giemsa staining, rapid urease test, Western blot serology, and [13C]urea breath test.
- Histological assessment served as the gold standard for H. pylori diagnosis.
Main Results:
- H. pylori was identified in 52.8% of patients via histology.
- The [13C]urea breath test showed 92.9% sensitivity and 96% specificity.
- Rapid urease test and serology demonstrated lower accuracy (78.6% sensitivity, 96% specificity; 78.6% sensitivity, 52% specificity, respectively).
Conclusions:
- The [13C]urea breath test is a highly accurate method for diagnosing H. pylori infection in cirrhotic patients.
- Serology and rapid urease tests provide less reliable diagnostic performance in this population.
Background:
In cirrhotics, Helicobacter pylori infection is the major cause of peptic lesions, which are an important cause of upper intestinal haemorrhage in these patients. However, some diagnostic methods are not accurate for H. pylori detection in cirrhotics.
Aims:
The study assessed the accuracy of different diagnostic methods for H. pylori detection in cirrhotics with and without gastroduodenal lesions.
Methods:
The study population comprised of 53 cirrhotics. All patients underwent upper endoscopy: three biopsies were taken in the antrum and three in the gastric body. Four biopsies were used for Giemsa staining, while two were used for a rapid urease test. A blood sample was obtained for serology using Western blotting, and a [13C]urea breath test was performed in all patients. Histological assessment was regarded as the gold standard for diagnosis of H. pylori infection.
Results:
H. pylori infection was detected at histological assessment in 28 (52.8%) patients. The [13C]urea breath test, rapid urease test, and serology were positive in 27 (51%) patients, 23 (43.4%) patients, and 34 (64.1%) patients, respectively. Sensitivity and specificity were 92.9 and 96% for the [13C]urea breath test, 78.6 and 96% for the rapid urease test, and 78.6 and 52% for serology.
Conclusions:
The [13C]urea breath test is very accurate in cirrhotics, whilst both serology and the rapid urease test give disappointing results.
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