Factors Influencing Eradication of Helicobacter pylori in Patients with Peptic Ulcer Disease

Kim, Jin Il; Chung, In Sik; Bhang, Choon Sang; Park, Soo Heon; Choi, Myung Gyu; Kim, Jae Kwang; Han, Sok Won; Sun, Hee Sik; Park, Doo Ho; Chang, Eun Deok

Abstract

BACKGROUND/AIMS: Recurrence of peptic ulcer is reduced with successful eradication of Helicobacter pylori. Now, the eradication rate of H. pylori is reported to be 80% with proton pump inhibitor based triple therapy in Korea. Factors influencing eradication are drug sensitivity, gastric pH and com pliance. To validate the other factors influencing H. pylori eradication, we prospectively evaluated 64 patients with peptic ulcer.
METHODS
Between September, 1997 and February, 1998, 32 patients with gastric ulcer and 32 patients with duodenal ulcer were involved in this study. Before the treatmen of H. pylori, we evaluated the presence of VacA and CagA, the density of H. pylori on gastric mucosa, inflammatory score in the antrum and the body, and the titer of H. pylori IgG antibody of the patients. Then, the 64 patients were treated with two weeks course of the triple therapy composed of amoxicillin, omeprazole, and clarithromycin. After treatment, all patients were performed upper endoscopy. The above six factors were assessed.
RESULTS
The overall eradication of H. pylori was achieved in 52 of 64 patients (81.3%). The factors such as VacA, the density of H. pylori in the antrum, chronic inflammatory score in the antrum, and the titer of anti-H. pylori IgG antibody influ enced the eradication rate (p=0.004, 0.026, 0.047 and 0.030 respectively).
CONCLUSIONS
Assessmen of inflammatory score, density of H. pylori and VacA are important in predicting the possibility oH. pylori eradication in patients with peptic ulcer disease.