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H. Pylori

H. Pylori. Helicobacter Pylori. History 1906 1982 (Warren and Marshall) Antibiotic was used Subsequently, they isolated a bacteria Self-experiments (Marshal ingested H. pylori) Hundreds of studies followed NIH

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H. Pylori

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  1. H. Pylori

  2. Helicobacter Pylori • History • 1906 • 1982 (Warren and Marshall) • Antibiotic was used • Subsequently, they isolated a bacteria • Self-experiments (Marshal ingested H. pylori) • Hundreds of studies followed • NIH • 1994 H. pylori infection was concluded to be a major cause of peptic ulcer (antibiotic therapy)

  3. Prevalence • It is a worldwide problem • ↑50% infected • Developed vs. Developing • Differences in prevalence due to a variety of factors?

  4. Factors associated with prevalence of H. pylori • Age • Ethnicity • Socioeconomic Status • Household crowding • Migration from high prevalence regions

  5. Age • Prevalence of H. pylori ↑ with age • Q. Does that reflect an ↑ of risk with age? • A. ?? • Birth cohort effect • Cohort studies • Childhood (factors) • Peak of acquisition between 3-4 yrs

  6. Ethnicity • Prevalence of H.pylori differs by ethnicity • In US more among Blacks and Hispanic • In Germany more among Turkish • In Singapore Indians>Chinese>Malays • Why? • Is it due to genetic differences • Is it other factors such as: • Crowding • Poverty • Education • Origination from highly prevalent areas Marker of a variety of lifestyle exposures, such as differences in standards of living or sanitation practices

  7. Socioeconomic status • Studies showed an inverse relationship • Some studies showed absence of the association between prevalence of H. pylori and SES level. • Q. How could you explain that? • How was the question asked? • Persistence • Due to limited variation in SES • Probably obscured due to complexity of defining and measuring SES

  8. Detection of H. pylori infection • Invasive • Noninvasive

  9. Invasive tests • Biopsy urease test • Histologic examination • Microbiologic culture

  10. Noninvasive tests • Serologic assays • Urea breath tests • Stool antigen test

  11. Transmission • Not well understood • Person to person but how? • Oral-oral • Fecal-oral • Gastro-oral • Waterborne • Zoonotic

  12. Thank you

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