The prevalence of Helicobacter pylori infection in the Netherlands

The prevalence of Helicobacter pylori has been declining in the developed countries, as it has the incidence of distal gastric carcinoma. Monitoring this decline and identifying populations not benefiting from this decline is a fit task for public health authorities, with blood donors an obvious source of sera.

We tested 1550 randomly selected blood donors, spread over 5-10 year age cohorts, from four regions in the southern half of The Netherlands, for the presence of antibodies against H. pylori and the CagA antigen. These donors were drawn from an area comprising 46% of the native Dutch population, but did not include non-European immigrants.

We observed an age specific decline in the mean seroprevalence of H. pylori from 48% for donors born between 1946 and 1935 to 16% for those born between 1987 and 1977. In H. pylori positive donors, the CagA seroprevalence declined from 38% to 14% in the same age cohorts. There were no significant differences between regions in either prevalence.

Our results are compatible with a persistent age-cohort phenomenon for H. pylori prevalence, with the most pronounced decline of CagA+ strains. Nevertheless, almost one in six of the young native Dutch population remains H. pylori positive, implying that, without specific intervention, this bacterium will remain common over the coming decades.