DOES INTRAFAMILIAL SPREAD PLAY A ROLE FOR HELICOBACTER PYLORI INFECTION IN CHILDREN

INTRODUCTION: Acquisition of Helicobacter pylori (Hp) infection in children occurs mainly in those under 5 years of age. OBJECTIVE: Our aim was to investigate intrafamilial spread of Hp infection. METHODS: One hundred symptomatic children without previous eradication treatment were investigated by gastroscopy and the 13C-urea breath test (UBT). All family members of each index patient were investigated by using the UBT. Infected members were estimated according to UBT results, and for those members who were UBT-negative and had recently received eradication therapy after confirmation of infection by endoscopy, the previous positivity was taken into account. RESULTS: Ηp infection was identified in 44 (44%) of 100 symptomatic index children. There was no statistical difference between Ηp+ and Ηp− index children concerning demographic factors except age, which was higher in Ηp+ index children ( P = .009). In all Ηp+ index children (100%) and in 71.4% of Ηp− children, at least 1 more family member was infected ( P < .001); in all cases (100%) at least 1 parent in the group of Ηp+ index children, compared with 69.6% in Ηp− index children ( P < .001), was infected. The rate of infected siblings of the Ηp+ index children was 43.2%, and that in the Ηp− group was 3.6% ( P < .001). There were more infected mothers in the Ηp+ index children group (83.7% vs 50% in the Ηp− group; P = .001) and more infected fathers (76.7% vs 56.4%, respectively; P = .035). CONCLUSIONS: The identification of at least 1 more infected member in each family of Hp+ index patients, including a parent in all cases, strongly indicates family as the main source of infection for children and confirms the hypothesis of intrafamilial spread of Hp. Submitted by Eleftheria Roma