Elevated Serum anti-Helicobacter pylori IgG Levels is a Predictor of Successful Eradication Therapy

Abstract

AIM : To identify a predictor of successful primary Helicobacter pylori ( H. pylori ) eradication assessed in routine clinical practice. METHODS : From February 2013 to January 2015, 186 patients underwent primary eradication therapy. We retrospectively reviewed the medical records. All patients underwent EGD before eradication therapy and H. pylori infection was diagnosed by ≥10 U/ml serum anti- H. pylori IgG. We used standard triple therapy including a proton pump inhibitor (PPI) (rabeprazole 10 mg or lansoprazole 30 mg), clarithromycin 200 mg and amoxicillin 750 mg twice daily for seven days. To determine if eradication succeeded, a 13 C-urea breath test was performed on all patients more than eight weeks after primary eradication. RESULTS : The overall success rate of H. pylori eradication therapy was 62% (116/186). We assessed potential predictors of successful primary H. pylori eradication therapy including gender, age, smoking habits, prior PPI intake, kind of PPI, serum IgG value and degree of atrophy. Univariate analysis showed that high serum IgG significantly predicts successful eradication (odds ratio (OR) 2.583, 95% confidence interval (CI) 1.285-5.191, p = 0.008). The eradication rate was 77% (43/56) in the ≥45 U/ml group and 56% (73/130) in the <45 U/ml group, and significance was confirmed by multivariate analysis (OR 2.626, 95% CI 1.269-5.436, p = 0.009). Multivariate analysis showed a trend that advanced age (≥70 year-old) increased the rate of successful eradication (OR 1.669, 95% CI 0.857-3.252, p = 0.132). CONCLUSION : Elevated serum IgG significantly predicts successful primary H. pylori eradication.