Abstract
Familial transmission can possibly influence the infection and treatment of Helicobacter pylori. This study aimed to describe the prevalence of H. pylori infection and outcomes of eradication treatment among Vietnamese patients who live in the same households. We conducted a prospective cohort study of Vietnamese household members with upper gastrointestinal complaints. Participants received esophagogastroduodenoscopy and H. pylori testing. The H. pylori-positive patients were treated and asked to return for follow-up within 4 months. To explore factors associated with H. pylori infection at baseline, we performed multilevel logistic regression to account for the clustering effect of living in the same households. To explore factors associated with eradication failure, we used Poisson regression with robust variance estimation to estimate the risk ratio. The prevalence of H. pylori infection was 83.5% and highest among children <12 years old (92.2%) in 1,272 patients from 482 households. There were variations in H. pylori infection across households (intraclass correlation = 0.14, 95% confidence interval (CI) 0.05, 0.33). Children aged <12 years had higher odds of H. pylori infection (odds ratio = 3.41, 95%CI 2.11, 5.50). At follow-up, H. pylori was eradicated in 264 of 341 patients (77.4%). The risk of eradication failure was lower for the sequential regimen with tetracycline. H. pylori infection was common among people living in the same households. Eradication success for H. pylori was higher for the tetracycline sequential regimen. More research should be focused on how family factors influence H. pylori infection and on eradication treatment.
Highlights
Helicobacter pylori is an important cause of gastric cancer [1], gastritis, peptic ulcer, and mucosa-associated lymphoid tissue lymphoma [2]
Eradication success for H. pylori was higher for the tetracycline sequential regimen
Despite variation in the prevalence trends among different pediatric age groups, the findings suggest that intrafamilial transmission might be a factor of H. pylori infection in children [25,26,27]
Summary
Helicobacter pylori is an important cause of gastric cancer [1], gastritis, peptic ulcer, and mucosa-associated lymphoid tissue lymphoma [2]. In addition to environmental and sanitary factors, behavioral factors, such as feeding children chewed food and consuming raw vegetables can cause intrafamilial transmission that can increase the risk of H. pylori infection [10,11,12,13,14,15]. H. pylori eradication has been a global challenge due to widespread antibiotic resistance. In Vietnam, the prevalence of resistance to antibiotics for H. pylori eradication has increased in recent years, and resistance to some antibiotics could reach >60% [9]. The “Whole family-based H. pylori eradication strategy” has been proposed to acknowledge the role of these factors to achieve better and sustainable eradication success, but the strategy remains controversial [17]
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