Intrafamilial transmission of Helicobacter pylori: the association between a parent and an offspring with respect to the presence of anti-CagA antibody

Family history of various cancers and pancreatic cancer mortality in a large cohort

A family history of pancreatic cancer is associated with increased risk of pancreatic cancer, but uncertainty remains about the magnitude of this association, whether it varies by age or smoking and whether a family history of other cancers may also be associated with increased risk. We examined family history of 14 cancers and pancreatic cancer mortality among ~1.1 million men and women in Cancer Prevention Study-II (CPS-II). CPS-II participants completed a questionnaire at enrollment in 1982. During follow-up through 2006, there were 7,306 pancreatic cancer deaths. A family history of pancreatic cancer in a parent or sibling was associated with pancreatic cancer mortality [multivariable adjusted rate ratio (RR) = 1.66, 95% confidence interval (CI) 1.43-1.94]. This association was stronger among participants aged under 60 (RR = 2.89, 95% CI 1.67-5.02) than among participants aged 60 or older (RR = 1.61, 95% CI 1.37-1.88). Weaker associations were observed for family history of stomach cancer (RR = 1.23, 95% CI 1.11-1.37), liver cancer (RR = 1.25, 95% CI 1.10-1.43), and colorectal cancer (RR = 1.12, 95% CI 1.01-1.23). Results from this large prospective study indicate family history of pancreatic cancer is associated with a moderate increase in risk of pancreatic cancer, and also identify associations with the family history of certain other cancers which may be useful in generating hypotheses about shared risk factors.

Intra-familial transmission of Helicobacter pylori infection in children of households with multiple generations in Vietnam

This community-based cross-sectional study in 533 participants from 135 households with multiple generations living in the same household aimed at investigating the relationship between Helicobacter pylori infection in children and the other household members. H. pylori infection in children was found significantly associated with the infection in mothers [OR (95% CI): 2.50 (1.19-5.26)], even after being adjusted for sex, age group and sibling number [adjusted OR (95% CI): 2.47 (1.12-5.47)]. It was also significantly associated with the infection in both parents [adjusted OR (95% CI): 4.14 (1.29-13.23)]. No significant association between H. pylori infection in the father, grandparent(s), uncle or aunt with that in their children was found. Results from the present study showed intra-familial transmission in a multi-generation population and supported the hypothesis of person-to-person transmission of H. pylori infection.

Is Helicobacter pylori infection a risk factor for acute coronary syndromes?

OBJECTIVES

To elucidate risk factors for acute coronary syndromes (ACS), the present study examined whether Helicobacter pylori infection is a risk factor for patients with ACS.

METHODS

We studied 33 male patients with acute coronary syndromes (ACS). All patients were incidence cases of ACS that they did not have a past history of IHD and were at the first onset of ACS. A control group was consisted of 66 males. Controls were at random selected from outpatients. All controls had normal resting electrocardiogram and had no history of IHD. H. pylori seropositivity was determined by an IgG-specific enzyme linked immunosorbent assay (ELISA). We serologically confirmed the presence of antibodies specific to the antigen CagA of H. pylori, using CagA ELISA.

RESULTS

Seropositive rate of IgG antibodies in patients with ACS was 87.9%. A rate of in controls was 66.7%. After adjustment for age, a statistically significant association was found in H. pylori seropositivity between ACS and controls (OR, 3.74; 95% CI, 1.15-12.13). This relation was also significant after adjusted for potential confounding factors (OR, 4.09; 95% CI, 1.10-15.17). Anti-CagA positive H. pylori were significantly recognized in ACS (adjusted OR, 3.58; 95% CI, 1.08-11.82). However, this significant association was disappeared after adjusted for potential confounding factors (P=0.054).

CONCLUSIONS

We confirmed a significant link between H. pylori infection and ACS. H. pylori infection is likely to be a risk factor for ACS.

Evidence of mother-child transmission of Helicobacter pylori infection

BACKGROUND

Low socioeconomical status is a major risk factor for natural acquisition of Helicobacter pylori (H. pylori) infection in developing countries. Its transmission route is unknown but studies suggest person-to-person transmission.

AIM

To evaluate seropositivity of anti-H. pylori antibodies in family members of infected symptomatic index patients as compared to family members of symptomatic uninfected index patients.

PATIENTS AND METHODS

One hundred and twelve family members of 38 patients who underwent endoscopy to exclude peptic disease were studied. Patients were deemed H. pylori infected or not infected when rapid urease test and histology were both positive or both negative. The family members underwent ELISA serology using the Cobas Core II Kit (Roche) and were classified into three groups: I - 29 family members of 10 H. pylori (+) duodenal ulcer index patients; II - 57 family members of 17 H. pylori (+) index patients without duodenal ulcer; III - 26 family members of 11 H. pylori (-) index patients.

RESULTS

Seropositivity of group I and II (infected patients) was higher than the control group, 83% vs 38%, specially in mothers, 81% vs 18%, and in siblings 76% vs 20%. Differences between fathers' seropositivity was not statistically significant in the three groups: 100% vs 86% vs 70%. Seropositivity of all family members (mother, father and siblings) between infected group (I vs II) was similar.

CONCLUSION

Prevalence of H. pylori infection was higher in family members of infected patients, but was similar among family members of infected patients with and without duodenal ulcer. H. pylori infection is more frequent in mothers and siblings of infected index children. A common source of infection cannot be excluded, but facts suggest that person-to-person transmission occurs, specially from mother to child.

Does seropositivity for Helicobacter pylori antibodies increase outpatient costs for gastric and duodenal ulcer or inflammation?

BACKGROUND

Helicobacter pylori is regarded as an important cause of both peptic ulcer and chronic gastritis. In particular, seropositivity is highest in patients with duodenal ulcer. No studies have determined whether there are differences in the direct medical costs associated with gastric/duodenal ulcer or inflammation, between seropositive and seronegative patients.

OBJECTIVE

To examine the relationship between seropositivity for H. pylori and outpatient visits and direct medical costs for gastric/duodenal ulcer or inflammation in Japan from the perspective of the payor and patients.

METHODS

Participants were males (n = 653) who worked for an agricultural co-operative in Fukuoka Prefecture, attended an annual health examination (including a written lifestyle and medical survey), belonged to the same health insurance society consistently for 4 years from April 1996 to March 2000, and provided a blood sample. The survey asked about lifestyle, including smoking and drinking, and past medical history. We retrospectively analysed the annual number of outpatient visits per person and outpatient medical cost (Yen, 2000 values) per person for visits relating to gastric or duodenal ulcer or inflammation using International Classification of Diseases (9th edition) -- Clinical Modification codes. We assessed for potential confounding factors using analysis of covariance and the chi-square test.

RESULTS

The annual outpatient incidence of disease, the number of visits to physicians, and the medical costs for gastric or duodenal ulcer or inflammation were about 2-fold greater in individuals with antibodies to H. pylori compared with those without antibodies.

CONCLUSION

Population-based studies and/or randomised controlled clinical trials that target high-risk groups and account for the unique way in which data are collected in Japan are needed to determine whether medical costs for gastric and duodenal ulcer might be reduced by treating asymptomatic patients who have antibodies to H. pylori.

Prevalence of Helicobacter pylori infection in Warao lineage communities of Delta Amacuro State, Venezuela

The purpose of this study was the evaluation of Helicobacter pylori infections in children and adults from two indigenous communities of Delta Amacuro State, Venezuela, that differ in hygienic conditions of the housing. The evaluation was performed in 98 children (mean age 7 +/- 3.37 years) and their mothers (33.96 +/- 13.77 years) from two communities of Warao lineage. Anti-H. pylori serum IgG and secretory anti-H. pylori IgA antibodies were determined, as well as total secretory IgA and H. pylori antigens in feces. Serological prevalence of H. pylori infection was 38% in children and 84% their in mothers. Children from the community that had the most deficient sanitary and hygienic conditions had significantly lower titers of specific IgG antibodies and total secretory IgA (P<0.0001) and a high percentage of them had H. pylori antigens in their feces (P<0.0001). The levels of specific IgA were similar in both groups. The results indicate that in these populations there is a high prevalence of H. pylori infection and that poor hygienic conditions can increase the risk of infection and damage to the gastrointestinal tract.

Helicobacter pylori and hepatitis A virus infection in school-aged children on two isolated neighborhood islands in Taiwan

BACKGROUND

The transmission routes of Helicobacter pylori and hepatitis A virus (HAV) infections have been extensively discussed in previous literature. However, whether H. pylori and HAV shared the same transmission pattern or not remains unclear. Lower socioeconomic status was recognized as a consistent risk factor to both infections. However, whether fecal-oral transmission was a risk factor to both infections is still under debate.

MATERIALS AND METHODS

In 1996, we conducted a cross-sectional study to evaluate the seroprevalence of antibody to H. pylori and HAV among the randomly selected school-aged children (age between 13 and 15) on Green Island (n = 91) and Lanyu Island (n = 138) (two isolated neighborhood islands near Taiwan Main Island).

RESULTS

The seroprevalence of H. pylori and HAV on the Green Island were 82.4% and 5.5%, respectively. The seroprevalence of H. pylori and HAV on Lanyu Island were 71.0% and 90.6%, respectively. H. pylori seroprevalence of all children and the subgroup of 13-year-olds was significantly lower on Lanyu Island than Green Island. However, it was not significantly different in subgroups of 14- and 15-year-olds. HAV seroprevalence was significantly higher on Lanyu Island than Green Island among all children and in each age subgroup. The correlation of H. pylori infection and HAV infection did not demonstrate significant linear correlation on both islands.

CONCLUSIONS

In conclusion, H. pylori and HAV infections in school-aged children of 13-15 years of age on Green Island and Lanyu Island did not demonstrate significant correlation. The results of this study imply that H. pylori and HAV may share different transmission routes of infection.

Epidemiology and diagnosis of Helicobacter pylori infection

There have been no major breakthroughs in the field of epidemiology and diagnosis of Helicobacter pylori infection over the last year, thus for this reason, these two topics will be treated in the same chapter. Information on the incidence of infection, as in the study of Malaty et al. are now being published from long-term cohort follow-ups. The route of transmission of H. pylori remains controversial, with circumstantial evidence for infection via exposure to animals, contaminated water supplies and oral reservoirs being reported. The value of citric acid to improve urea breath test (UBT) results has been documented. A novel stool test has been released on the market and we are awaiting more information, while detection of antibodies in urine gave satisfactory results. However, the most interesting data comes from the study of McColl et al. who clearly proved on a large sample and a 1-year follow-up that the 'test and treat' strategy using UBT, as proposed in the Maastricht Consensus Report, is definitely the method to use.