Recurrence of Helicobacter pylori infection and the affecting factors: A follow-up study

OBJECTIVE: Recurrence of Helicobacter pylori (H. pylori) infection weakens the protective effect and long-term prognosis of eradication. With the widespread therapies, decreasing prevalence of H. pylori infection and improvement in living conditions, the recurrence of H. pylori infection may present with new features. We conducted this prospective, large-scale, multicenter follow-up study to determine the recurrence rate of H. pylori infection and its affecting factors. METHODS: A total of 827 patients receiving successful H. pylori eradication in our previous randomized controlled trial were enrolled. C-13-urea breath test (UBT) was repeated one year after the eradication therapy to determine its recurrence. Moreover, a questionnaire survey was performed to explore the potential factors affecting the recurrence. RESULTS: A total of 743 patients completed C-13-UBT (follow-up rate 89.8%), and the result was positive in 13 patients one year after eradication therapy, with an annual recurrence rate of 1.75% (95% confidence interval [CI] 0.81-2.69%). Six hundred and ninety-two patients (13 with recurrence and 679 without recurrence) returned their questionnaires, with a response rate of >80%. Multivariate analysis revealed that peptic ulcer (odds ratio [OR] 3.385, 95% CI 1.016-11.274), close contact with individuals having H. pylori infection (OR 4.231, 95% CI 1.201-14.911), and hospitalization (OR 9.302, 95% CI 2.441-35.440) were independent risk factors of H. pylori infection recurrence. CONCLUSIONS: The recurrence of H. pylori infection one year after eradication therapy is low in urban population of China. Peptic ulcer, contact history with individuals having H. pylori infection and hospitalization are risk factors.