Rate and predictive factors of Helicobacter pylori recurrence: Analysis of a screening cohort

The aim of the study was to identify the recurrence rate of Helicobacter pylori after successful eradication in an endemic area and investigate baseline and clinical factors related to the recurrence.

H. pylori infected patients from a screening cohort of National Cancer Center between 2007 and 2012 were enrolled in the study. A total of 647 patients who were confirmed to be successfully eradicated were annually followed by screening endoscopy and rapid urease test. Median follow-up interval was 42 months. Annual recurrence rate of H. pylori was identified. Demographics, clinical factors, and endoscopic findings were compared between H. pylori recurrence group and persistently eradicated group (control group).

H. pylori recurrence was observed in 21 (3.25%) patients. Its annual recurrence rate was 0.91% (1.1% in males and 0.59% in females). Mean age was higher in the recurrence group than that in the control group (55.9 vs 50.7, P = 0.006). Median follow-up was shorter in the recurrence group than that in the control group (34 vs. 42.5 months, P = 0.031). In multivariate analysis, OR for H. pylori recurrence was 1.08 per each increase in age (P = 0.012). Adjusted ORs for H. pylori recurrence were 0.20 (95% CI: 0.06-0.69) and 0.25 (95% CI: 0.08-0.76) in age groups of 50-59 years and less than 50 years, respectively, compared to the group aged 60 years or older.

H. pylori recurrence rate in Korea is very low after successful eradication. Advanced age is at increased risk for H. pylori recurrence. Thus, H. pylori treatment for patients who are under 60 years of age is more effective, leading to maintenance of successful eradication status.