Helicobacter最新文献

{"title":"Bismuth–Amoxicillin–Vonoprazan Triple, Amoxicillin–Vonoprazan Dual, and Clarithromycin-Based Triple Therapies for First-Line Treatment of Helicobacter pylori Infection: A Multicenter, Open-Label, Randomized Trial","authors":"Ping-I Hsu,&nbsp;Ming-Jen Sheu,&nbsp;Chien-Lin Chen,&nbsp;Wei-Yi Lei,&nbsp;Chih-An Shih,&nbsp;Feng-Woei Tsay,&nbsp;Sung-Shuo Kao,&nbsp;Chang-Bih Shie,&nbsp;Pei-Jui Wu,&nbsp;Chao-Hung Kuo,&nbsp;Jyh-Chin Yang,&nbsp;Kuan-Yang Chen,&nbsp;Seng-Kee Chuah,&nbsp;Chia-Long Lee,&nbsp;Hsi-Chang Lee,&nbsp;Wei-Chen Tai,&nbsp;Tzung-Jiun Tsai,&nbsp;John Y. Kao,&nbsp;Deng-Chyang Wu,&nbsp;the Taiwan Acid-related Disease & Microbiota (TARD-M) Consortium","doi":"10.1111/hel.70131","DOIUrl":"10.1111/hel.70131","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The eradication rate of amoxicillin–vonoprazan (AV) dual therapy for <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection varies by region and is below 90% in both the United States and Taiwan. We recently added bismuth to this regimen, and the resulting bismuth–amoxicillin–vonoprazan (BAV) triple therapy achieved eradication rates ≥ 95% in Taiwan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To compare the efficacy and safety of 14-day BAV triple therapy with AV dual therapy and clarithromycin–amoxicillin–rabeprazole (CAR) standard triple therapy as first-line regimens for <i>H. pylori</i> eradication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this multicenter, randomized, open-label trial, adults with <i>H. pylori</i> infection were randomized (1:1:1) to receive one of the following 14-day regimens: BAV triple therapy (tripotassium dicitrato bismuthate 300 mg four times daily, amoxicillin 750 mg four times daily, and vonoprazan 20 mg twice daily), AV dual therapy (vonoprazan 20 mg twice daily and amoxicillin 750 mg four times daily), or CAR standard triple therapy (rabeprazole 20 mg, amoxicillin 1 g, and clarithromycin 500 mg twice daily). Eradication was assessed by the ¹³C-urea breath test. The primary endpoint was eradication in the intention-to-treat population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between November 2023 and June 2025, 390 patients were enrolled. Intention-to-treat eradication rates were 93.8% with BAV therapy, 83.8% with AV therapy, and 83.1% with CAR therapy. BAV therapy was superior to both AV therapy (95% CI, 2.4%–17.6%; <i>p</i> = 0.010) and CAR therapy (95% CI, 3.0%–18.4%; <i>p</i> = 0.007). Per-protocol eradication rates were 97.5%, 88.3%, and 88.0%, respectively; BAV therapy remained superior to AP therapy (<i>p</i> = 0.010) and CAR therapy (<i>p</i> = 0.05). Overall adverse event rates (10.8%, 8.5%, and 13.8%) were comparable. Amoxicillin resistance and clarithromycin resistance were identified as risk factors for eradication failure with BAV and CAR therapies, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BAV triple therapy demonstrates superior efficacy compared with AV dual therapy and CAR triple therapy as first-line treatment for <i>H. pylori</i> infection in Taiwan. This regimen represents a promising first-line option that may obviate the need for routine clarithromycin-resistance testing in regions where AV dual therapy yields suboptimal eradication rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 4","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local Price and Clarithromycin Resistance Shape the Cost of Vonoprazan Triple Therapy for Helicobacter pylori Eradication","authors":"Christos Zavos","doi":"10.1111/hel.70160","DOIUrl":"https://doi.org/10.1111/hel.70160","url":null,"abstract":"","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 4","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"14-Day Vonoprazan–Minocycline Dual Therapy Versus Bismuth-Containing Quadruple Therapy for Helicobacter pylori Rescue Treatment: A Single-Center Randomized Controlled Noninferiority Trial","authors":"Tingting Yang,&nbsp;Ruijuan Xin,&nbsp;Yanhong Deng,&nbsp;Jun Liu,&nbsp;Xue Li,&nbsp;Xiaole Guo,&nbsp;Linke Ma,&nbsp;Xiaoming Su,&nbsp;Yanxia Liu,&nbsp;Chengdong Su,&nbsp;Qian Hao,&nbsp;Rui Mu,&nbsp;Xiaofei Li,&nbsp;Pengda Wang,&nbsp;Yanling Li,&nbsp;Xue Zhang,&nbsp;Qingrui Li,&nbsp;Yuting Wu,&nbsp;Shengjuan Hu","doi":"10.1111/hel.70153","DOIUrl":"https://doi.org/10.1111/hel.70153","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Rescue treatment for <i>Helicobacter pylori</i> infection remains challenging in regions with high antibiotic resistance. Although bismuth-containing quadruple therapy is widely recommended as an empirical rescue regimen, its medication burden may impair tolerability and adherence. This trial evaluated the efficacy and safety of 14-day vonoprazan–minocycline dual therapy compared with vonoprazan-based bismuth-containing quadruple therapy as empirical rescue treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This single-center, prospective, open-label, randomized, controlled, noninferiority trial enrolled 186 adults aged 18–70 years with at least one previous <i>H. pylori</i> eradication failure. Patients were randomly assigned (1:1) to receive 14-day vonoprazan–minocycline dual therapy or vonoprazan-, amoxicillin-, minocycline-, and bismuth-containing quadruple therapy. Eradication was assessed by a ¹³C urea breath test 4 weeks after treatment. ITT, mITT, and PP analyses were performed, with a prespecified noninferiority margin of −10%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eradication rates in the dual therapy and quadruple therapy groups were 89.2% and 91.4% in the ITT analysis (difference, −2.2%; 95% CI, −10.5% to 6.2%; noninferiority <i>p</i> = 0.036), 90.2% and 92.4% in the mITT analysis (difference, −2.2%; 95% CI, −9.7% to 5.3%; noninferiority <i>p</i> = 0.030), and 91.2% and 93.4% in the PP analysis (difference, −2.2%; 95% CI, −9.4% to 5.0%; noninferiority <i>p</i> = 0.024). Noninferiority was demonstrated in the mITT and PP analyses, whereas the ITT result should be interpreted cautiously because the lower 95% CI bound crossed the margin. Adverse events were similar between treatment groups (11.8% vs. 15.1%; <i>χ</i>² = 0.416; <i>p</i> = 0.519), and adherence was high in both groups (97.8% vs. 97.8%; <i>p</i> = 1.000).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>14-day vonoprazan–minocycline dual therapy achieved eradication rates comparable to those of bismuth-containing quadruple therapy, with acceptable safety and high adherence as rescue treatment for <i>H. pylori</i> infection. This simplified regimen may be considered a potential empirical rescue option when susceptibility testing is not readily available, although the ITT noninferiority result warrants cautious interpretation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 4","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70153","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Decade of Screening and Treating Helicobacter pylori Infection Among First-Year High School Students in Kyoto, Japan: Annual Trends in Infection, Consultation, and Eradication Success Rates (2015–2023)","authors":"Osamu Handa,&nbsp;Kazuhiko Uchiyama,&nbsp;Tomohisa Takagi,&nbsp;Yuji Naito","doi":"10.1111/hel.70156","DOIUrl":"10.1111/hel.70156","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> infection is a primary cause of gastric cancer. Although eradication therapy in adulthood suppresses carcinogenesis, its efficacy is limited due to the progression of advanced gastric mucosal atrophy before eradication. Implementing a “screen-and-treat” strategy during adolescence represents a promising approach to prevent advanced atrophy and subsequent gastric cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective cohort study included first-year high school students in Kyoto Prefecture, Japan, from 2015 to 2023. Screening was performed using a primary urine <i>H. pylori</i> antibody test, followed by a secondary stool antigen test for confirmation. Confirmed positive individuals were referred to designated medical institutions for 7-day eradication therapy. The primary therapeutic regimen was shifted from rabeprazole, amoxicillin, and clarithromycin (PAC) in 2015 to rabeprazole, amoxicillin, and metronidazole (PAM) from 2016 onward. <i>Clostridium butyricum</i> MIYAIRI 588 strain (CBM588) was co-administered starting in 2017. Eradication success was verified via a stool antigen test at least 8 weeks post-treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 50,031 students were targeted over the 9-year period, with an overall consent rate ranging from 59.9% to 83.9%. The confirmed <i>H. pylori</i> infection rate declined from 4.7% in 2015 to 1.5% in 2023. The medical consultation rate among positive screenees exhibited a declining trend, peaking at 84.6% (2015) and dropping to 15.8% (2023), despite a temporary increase in 2019 (65.9%). The eradication success rate significantly improved from 76.5% with the PAC regimen (2015) to over 93.8% with the PAM regimen (2016 onward), exceeding 96.0% after the addition of CBM588. No serious adverse events were reported throughout the study period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The prospective adolescent screen-and-treat program demonstrated a significant decrease in <i>H. pylori</i> infection rates among first-year high school students over the decade. While the safety and efficacy of the PAM-based eradication regimen were verified, declining medical consultation rates present a continuous challenge for public health implementation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 4","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70156","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy of Serum Antibody, Urine Antibody, and Stool Antigen Tests for Helicobacter pylori in Japan: A Systematic Review and Meta-Analysis","authors":"Chikamasa Ichita,&nbsp;Fumiaki Ishibashi,&nbsp;Yasuhiro Hagiwara,&nbsp;Ayaka Takasu,&nbsp;Yuichiro Kemmoto,&nbsp;Ran Li,&nbsp;Chika Kusano,&nbsp;Tianyi Wei,&nbsp;Yutaka Matsuyama,&nbsp;Nobutake Yamamichi,&nbsp;Manami Inoue,&nbsp;Hideki Ishikawa,&nbsp;Takuji Gotoda","doi":"10.1111/hel.70157","DOIUrl":"10.1111/hel.70157","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Non-invasive <i>Helicobacter pylori</i> (<i>H. pylori</i>) tests are widely used in clinical practice in Japan; however, their diagnostic accuracy may vary with the composition of the target population, and no systematic review has synthesized their performance specifically in Japanese populations. Therefore, we conducted a systematic review and meta-analysis to evaluate the diagnostic accuracy of serum antibody, urine antibody, and stool antigen tests for <i>H. pylori</i> infection in Japanese populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>MEDLINE, Embase, and Ichushi-Web were searched for studies published between 2005 and 2024 evaluating serum antibody, urine antibody, or stool antigen tests in Japanese participants. The primary objective involved evaluation of diagnostic accuracy for current <i>H. pylori</i> infection, and the secondary objective involved assessment of accuracy for ever-infected individuals. Summary estimates were calculated using bivariate random-effects models. A subgroup analysis was performed under clinically relevant conditions, restricted to studies without previously infected individuals, with composite reference standards, and without application of post hoc cutoff values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 806 publications, 43 studies were selected (serum antibody, 29; urine antibody, six; stool antigen, eight). For diagnosing current <i>H. pylori</i> infection, the summary sensitivity/specificity measured 0.922/0.956 for serum antibody, 0.885/0.970 for urine antibody, and 0.928/0.972 for stool antigen tests. For diagnosing ever-infected individuals, the summary sensitivity/specificity measured 0.908/0.960 for serum antibody and 0.888/0.969 for stool antigen. Under clinically relevant conditions, serum antibody and stool antigen yielded sensitivities/specificities of 0.908/0.968 and 0.935/0.985, respectively. In serum antibody studies, studies with previously infected individuals showed lower accuracy (sensitivity/specificity, 0.876/0.861) than studies without previously infected individuals (0.929/0.967).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Serum antibody and stool antigen tests demonstrated high diagnostic accuracy for current <i>H. pylori</i> infection in Japanese populations, although accuracy declined in studies with previously infected individuals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 4","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"School-Based Helicobacter pylori Screening for Adolescents in Japan: Current Status, Challenges, and Implications: A Narrative Review","authors":"Eisuke Kameoka,&nbsp;Hiroaki Saito,&nbsp;Takuto Hikichi,&nbsp;Jun Nakamura,&nbsp;Tsunetaka Kato,&nbsp;Takumi Yanagita,&nbsp;Mitsuru Otsuka,&nbsp;Masao Kobayakawa,&nbsp;Masaharu Tsubokura,&nbsp;Hiromasa Ohira","doi":"10.1111/hel.70159","DOIUrl":"10.1111/hel.70159","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Japan has a high incidence of gastric cancer and is currently the only nation in which guidelines recommend <i>Helicobacter pylori</i> screening for adolescents. However, the implementation and implications of these initiatives have not been comprehensively characterized. The aim of this study was to provide a comprehensive overview of <i>H. pylori</i> screening programs for adolescents in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A narrative review was conducted to summarize the studies on <i>H. pylori</i> screening among adolescents in Japan. Literature searches were performed in PubMed, Ichushi-Web, CiNii Research, and J-STAGE for articles published up to February 12, 2026. Studies that described <i>H. pylori</i> screening programs targeting adolescents in Japan were included. Data were extracted on study background and objectives, target age, screening methods, participation rates, infection prevalence, eradication regimens, eradication success rates, and adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventeen studies met the inclusion criteria. Screening programs were typically local-government-led and school-based and primarily targeted junior high school students. A two-step diagnostic strategy employing noninvasive tests was commonly used. The median prevalence of <i>H. pylori</i> infection was 3.1%. Eradication regimens varied across programs; metronidazole- or vonoprazan-containing regimens generally showed higher eradication success rates than proton pump inhibitor-based clarithromycin-containing regimens, although cross-study comparisons should be interpreted cautiously because of heterogeneity. Adverse events were generally mild and predominantly gastrointestinal, and no serious complications were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Local-government-led and school-based <i>H. pylori</i> screening among adolescents in Japan represents a feasible approach to the prevention of gastric cancer within a well-established school health system. The applicability of this strategy to other countries depends on several contextual factors, including the incidence of gastric cancer, health care infrastructure, and the presence of organized school health systems. In settings that lack these conditions, alternative community-based strategies may be required.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 4","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Value of the Pylori DuoTect Test for Helicobacter pylori Detection in the Vietnamese Population","authors":"Hang Dao Viet,&nbsp;Binh Nguyen Phuc,&nbsp;Thao Dang Thi,&nbsp;Trang Nguyen Thi Huyen,&nbsp;Thuong Nguyen Thu,&nbsp;Uyen Vu Thi Thu,&nbsp;Long Hoang Bao,&nbsp;Long Dao Van","doi":"10.1111/hel.70155","DOIUrl":"10.1111/hel.70155","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the diagnostic accuracy in <i>Helicobacter pylori</i> detection using blood test with FliD and CagA antibodies (Pylori DuoTect), comparing with rapid urease test (RUT) and urease breath test (UBT) in Vietnamese patients with upper GI symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted at the Institute of Gastroenterology and Hepatology in Hanoi, Vietnam on adults with upper GI symptoms, no prior treatment of peptic ulcers, and no history of <i>H. pylori</i> infection. Participants underwent upper GI endoscopy and three <i>H. pylori</i> tests, including rapid urease test (RUT), urea breath test (UBT), and Pylori DuoTect. Pylori DuoTect was considered positive if either FliD or CagA antibodies were detected. The <i>H. pylori</i> infection was defined as both RUT and UBT positive. Endoscopic findings were classified using the Kyoto classification score for gastritis. Diagnostic accuracy was evaluated using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From December 1, 2023, to August 9, 2024, 333 patients were recruited (mean age 45.9 years, 39.9% male). The most common symptom was epigastric pain (49.5%). The prevalences of gastritis, gastric ulcers, and duodenal ulcers were 92.7%, 12.1%, and 8.1%, respectively. Pylori DuoTect was positive in 51.9% of patients (FliD: 34.8% and CagA: 66.6%). Using the gold standard, 33.6% were diagnosed with <i>H. pylori</i> infection. The sensitivity, specificity, PPV, and NPV of Pylori DuoTect were 83.0%, 64.0%, 54.0%, and 88.0%, respectively. Combining Pylori DuoTect and endoscopy findings (peptic ulcer or Kyoto score ≥ 2) improved the sensitivity from 0.83 to 0.88 and increased NPV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pylori DuoTect had moderate sensitivity and low specificity in the diagnosis of <i>H. pylori</i> infection in Vietnamese adult patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 4","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial Resistance Profile of Helicobacter pylori in Shenzhen, China: A Retrospective Study From 2021 to 2024","authors":"Fan Wu,&nbsp;Ye Chen,&nbsp;Chenghai Yang","doi":"10.1111/hel.70154","DOIUrl":"https://doi.org/10.1111/hel.70154","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The escalating antibiotic resistance of <i>Helicobacter pylori</i> (<i>H. pylori</i>) poses a significant threat to global public health. Continuous local surveillance is crucial due to substantial geographical and temporal variations in resistance patterns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to characterize the antimicrobial resistance profile of <i>H. pylori</i> in Shenzhen, China, between 2021 and 2024, and to assess temporal trends and demographic associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective analysis of patients who underwent gastroscopy at Shenzhen Hospital of Southern Medical University from March 2021 to October 2024. Gastric mucosal biopsies were collected for <i>H. pylori</i> culture, and antimicrobial susceptibility testing was performed using the agar dilution method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among culture-positive isolates, 225 were from treatment-naïve patients and 975 from previously treated patients. Resistance rates in the treatment-naïve vs. previously treated groups were: clarithromycin 17.8% vs. 68.0%, metronidazole 87.1% vs. 97.4%, levofloxacin 11.1% vs. 50.9%, amoxicillin 0.4% vs. 3.1%, and furazolidone 0% vs. 0.1%. No tetracycline-resistant isolates were identified. Significant temporal increases were observed in secondary resistance to clarithromycin, amoxicillin, and metronidazole, as well as in the prevalence of multidrug resistance (all <i>p</i> &lt; 0.05). No sex-based differences were detected in either primary or secondary resistance rates (all <i>p</i> &gt; 0.05). Secondary resistance to clarithromycin, metronidazole, and levofloxacin varied significantly across age groups (<i>p</i> &lt; 0.05), whereas primary resistance rates did not.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Between 2021 and 2024, <i>H. pylori</i> isolates in Shenzhen exhibited high resistance rates to metronidazole, clarithromycin, and levofloxacin, while susceptibility to amoxicillin, furazolidone, and tetracycline remained preserved. Secondary resistance rates increased progressively over time, accompanied by a growing burden of multidrug resistance. Bismuth-containing quadruple therapy and high-dose dual therapy are recommended as first-line empirical regimens for treatment-naïve patients, whereas susceptibility-guided therapy is warranted for those with prior treatment failure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 4","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Potency Proton Pump Inhibitor Versus Vonoprazan in Helicobacter pylori Triple Therapy","authors":"Mimi C. Tan,&nbsp;Robert L. Atmar,&nbsp;David Y. Graham","doi":"10.1111/hel.70152","DOIUrl":"10.1111/hel.70152","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The price of vonoprazan in the United States, as with many newly introduced drugs, is currently high. Here, we examined the cost-effectiveness of vonoprazan clarithromycin triple therapy for treatment of <i>Helicobacter pylori</i> in the United States. We compared cure rates and total treatment costs to achieve ≥ 90% cure with either vonoprazan or proton pump inhibitor (PPI) triple therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We simulated a theoretical population and compared 4 scenarios comparing vonoprazan 20 mg twice daily or esomeprazole 40 mg twice daily. These included: (1) empiric vonoprazan versus esomeprazole clarithromycin triple therapy, (2) susceptibility-based vonoprazan versus esomeprazole clarithromycin triple therapy, (3) empiric vonoprazan versus esomeprazole clarithromycin triple therapy with treatment failures receiving bismuth quadruple therapy, and (4) susceptibility-based vonoprazan versus esomeprazole clarithromycin triple therapy with treatment failures receiving bismuth quadruple therapy. The prevalence of clarithromycin resistance was estimated at 30%. Cure rates were based on the <i>H. pylori</i> treatment nomogram and drug costs on U.S. 2025 retail prices (i.e., $50 for PPI and $960 for vonoprazan triple therapy).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>With 30% resistance, susceptibility-based therapy was the most effective (cure rate 92%). With empiric therapy, the cure rate with vonoprazan was higher than esomeprazole (88% vs. 77%) but overall costs increased 2.4–5.2 times. The cost per 1000 patients receiving vonoprazan was approximately $1000,000 versus $50,000 for esomeprazole. The least expensive, highly effective scenario was empiric esomeprazole triple therapy with treatment failures receiving bismuth quadruple therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Any treatment advantage of vonoprazan over PPI in clarithromycin triple therapy is restricted to those with clarithromycin resistance. Vonoprazan triple therapies cost 2 to 5 times more than a high potency PPI with small gains in cure rates. For susceptible infections, triple therapy using a high potency PPI should be preferred, and the most cost-effective strategy is to reserve vonoprazan for refractory cases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 4","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-Based Guidelines for the Diagnosis and Treatment of Helicobacter pylori Infection in Korea: 2025 Revised Edition","authors":"Chang Seok Bang,&nbsp;Seung Joo Kang,&nbsp;Hyunchul Lim,&nbsp;Seung Han Kim,&nbsp;Moon Won Lee,&nbsp;Su Youn Nam,&nbsp;Chung Hyun Tae,&nbsp;Sung Eun Kim,&nbsp;Seung Young Kim,&nbsp;Hye-Kyung Jung,&nbsp;Beom Jin Kim,&nbsp;Miyoung Choi,&nbsp;Hwoon-Yong Jung,&nbsp;Byung-Wook Kim,&nbsp;Korean College of Helicobacter and Upper Gastrointestinal Research","doi":"10.1111/hel.70149","DOIUrl":"10.1111/hel.70149","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Aims</h3>\u0000 \u0000 <p>Since the 2020 Korean guidelines for <i>Helicobacter pylori</i> treatment, clarithromycin resistance rates have risen from 17.8% to 33.3%, dual-priming oligonucleotide-based polymerase chain reaction (DPO-PCR)-based tailored therapy has been adopted, and P-CABs have become available. This fourth revision addresses these changes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nine key questions were addressed through systematic reviews with meta-analyses. Thirteen recommendations were evaluated via modified Delphi process involving 64 experts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twelve recommendations achieved first-round consensus; one required revision and achieved 73.9% agreement. Key changes: (1) dual-pillar strategy of tailored therapy and empirical quadruple therapy; (2) restricted use of empirical clarithromycin-based triple therapy under specific conditions; (3) removal of sequential therapy; (4) P-CABs as PPI alternatives; (5) expansion of eradication indications to include gastric cancer prevention in <i>H. pylori</i> gastritis and regression of hyperplastic polyps ≤ 10 mm; and (6) positioning of bismuth quadruple therapy as a conditionally recommended first-line empirical option with preference for reservation as salvage therapy, and introduction of modified bismuth quadruple therapy (addition of bismuth to conventional regimens) as an additional first-line empirical option.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This fourth revised guideline provides updated, evidence-based recommendations for the diagnosis and treatment of <i>H. pylori</i> infection, reflecting the rapidly changing antibiotic resistance landscape and the introduction of new diagnostic and therapeutic tools in Korea. These guidelines aim to assist clinicians, patients, policymakers, and medical educators in optimizing <i>H. pylori</i> management. They may differ from current medical insurance standards and will be revised further based on emerging evidence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 4","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}