Helicobacter最新文献

{"title":"Intermediate OLGA/OLGIM Stages as Early Risk Markers for Gastric Cancer: A Systematic Review and Meta-Analysis","authors":"Juan Sebastián Frías-Ordóñez,&nbsp;Sebastián Niño-Ramírez,&nbsp;Juan Camilo Pérez,&nbsp;Katherine Caita,&nbsp;José Darío Portillo-Miño,&nbsp;Arnoldo Riquelme Pérez,&nbsp;Lina Otero-Parra,&nbsp;Hernando Marulanda-Fernández,&nbsp;Elder Otero-Ramos,&nbsp;William Otero-Regino","doi":"10.1111/hel.70168","DOIUrl":"10.1111/hel.70168","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastric Intestinal Metaplasia Assessment (OLGIM) systems stratify gastric cancer (GC) risk according to the extent of gastric atrophy and intestinal metaplasia. However, the clinical significance of intermediate stages remains uncertain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the association between OLGA/OLGIM stages and GC, with particular focus on the potential role of intermediate stages as early histological risk markers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis (PROSPERO CRD42024549931) was conducted according to PRISMA 2020 guidelines. Cohort, case–control, and cross-sectional studies reporting GC incidence or prevalence according to OLGA and/or OLGIM stage were included. Methodological quality was assessed using the Newcastle-Ottawa Scale and certainty of evidence using GRADE. Random-effects models were used to calculate pooled odds ratios (OR) and risk ratios (RR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-eight studies involving 23,390 patients were included. Methodological quality was high and certainty of evidence was moderate. Advanced OLGA III–IV and OLGIM III–IV stages were strongly associated with GC (OR 6.49 and 7.76; RR 13.26 and 4.34, respectively). Intermediate stages were also associated with GC in observational studies: OLGA II (OR 2.77; 95% CI 1.83–4.20; <i>I</i>² = 71%) and OLGIM II (OR 3.63; 95% CI 2.90–4.55; <i>I</i>² = 0%). However, prospective cohort studies did not demonstrate a statistically significant increase in future GC incidence for OLGA II (RR 1.20; 95% CI 0.85–1.69).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Intermediate OLGA and OLGIM stages may represent early histological markers associated with gastric carcinogenesis. Prospective studies are required to determine their predictive value and potential implications for surveillance strategies, particularly in high-incidence populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181429","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":"Efficacy of Standard Triple Therapy With or Without Statin in Helicobacter pylori Eradication: A Randomized Double-Blind Placebo-Controlled Trial","authors":"Chitchai Rattananukrom,&nbsp;Punnaphol Waranophirun,&nbsp;Anupol Panitchote,&nbsp;Suda Vannaprasaht,&nbsp;Tanita Suttichaimongkol,&nbsp;Kookwan Sawadpanich,&nbsp;Apichart Sangchan,&nbsp;Wattana Sukeepaisarnjaroen,&nbsp;Pisaln Mairiang,&nbsp;Witsarut Manasirisuk","doi":"10.1111/hel.70171","DOIUrl":"10.1111/hel.70171","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Standard triple therapy (STT) for <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection has become suboptimal. Atorvastatin may improve eradication rates by promoting autophagy and reducing inflammation. This study aimed to evaluate the efficacy and safety of adjuvant atorvastatin with STT compared to STT alone for <i>H. pylori</i> eradication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this randomized, placebo-controlled trial, 138 treatment-naïve patients with <i>H. pylori</i> infection were randomized to two groups. The intervention group (<i>n</i> = 70) received a 14-day regimen of omeprazole, amoxicillin, clarithromycin, and atorvastatin (40 mg once daily). The control group (<i>n</i> = 68) received the same regimen with a matching placebo. The primary endpoint was <i>H. pylori</i> eradication, assessed by a urea breath test 4–6 weeks after treatment completion. Secondary endpoints included <i>CYP2C19</i> and <i>CYP3A4/5</i> genotypes, adverse events, and patient compliance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The eradication rate in the intervention group was significantly higher than in the control group in both the per-protocol (97.1% vs. 85.3%) and intention-to-treat (ITT) analyses (95.7% vs. 85.3%). The absolute risk difference for the ITT analysis was 10.4% (95% CI, 0.75 to 20.1; <i>p</i> = 0.03). The distribution of <i>CYP2C19</i> and <i>CYP3A4/5</i> genotypes was similar between groups. No clinically significant differences in adverse events were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Adjuvant therapy with atorvastatin combined with STT significantly improved <i>H. pylori</i> eradication rates without clinically significant adverse events. Further randomized controlled trials in diverse populations and with varying antibiotic resistance patterns are needed to better clarify the effects of statins on <i>H. pylori</i> treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Thai Clinical Trial Registry, No. TCTR20220201001</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181358","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":"Management Strategies for Helicobacter pylori—Application of the Stewardship Principles","authors":"Francis Megraud,&nbsp;Emilie Bessède,&nbsp;Tamara Matysiak-Budnik","doi":"10.1111/hel.70158","DOIUrl":"10.1111/hel.70158","url":null,"abstract":"<p>The management strategies for <i>Helicobacter pylori</i> treatment are still diverse, especially because of the unequal availability of the drugs needed. In addition, the development of resistance to some antibiotics leads to unsatisfactory results. The role of <i>H. pylori</i> in gastric cancer, which allows the possibility of prevention in the general population by eradicating the bacteria, is a stimulus to have well-established regimens. This article presents the antimicrobial stewardship principles that can guarantee appropriate treatment. The optimization of the clarithromycin-based triple therapy includes antimicrobial susceptibility testing for clarithromycin, a higher dose of amoxicillin than in the original regimen, more than twice a day, and a proton pump inhibitor (PPI) like rabeprazole or esomeprazole, all administered for 2 weeks. The other regimen often used, the bismuth quadruple therapy, is optimal with the 3-in-1 capsule and a standard or high dose of PPI. In all cases, an eradication control must be performed after 4 to 6 weeks. The so-called concomitant treatment does not meet stewardship principles. The availability of Potassium-Competitive Acid Blockers (P-CABs) in some countries could allow the use of a dual therapy with only amoxicillin, but it must be confirmed by proper trials in Western countries.</p>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181478","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":"Opportunistic Gastric Cancer Endoscopic Screening Integrated Into Population-Based Colorectal Cancer Screening: A Retrospective Economic Cost-Comparison Study","authors":"B. Mourato,&nbsp;P. Pinto,&nbsp;J. Vieira,&nbsp;M. Vidinha,&nbsp;V. Carvalho,&nbsp;N. Pratas,&nbsp;H. Capote,&nbsp;I. Fronteira,&nbsp;R. Dinis,&nbsp;M. Areia","doi":"10.1111/hel.70161","DOIUrl":"10.1111/hel.70161","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gastric cancer (GC) remains a major cause of cancer-related mortality worldwide, with prognosis and treatment costs strongly influenced by disease stage at diagnosis. Endoscopic GC screening has been proposed for intermediate-to-high-risk countries, although its economic feasibility remains uncertain. This study evaluated the costs associated with opportunistic GC screening integrated into a colorectal cancer screening programme and compared modeled early-stage management scenarios with the real-world costs of managing Stages II–IV disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cost-comparison study was conducted from the perspective of the Portuguese National Health Service. Screening costs were derived from 377 fecal immunochemical testing-positive individuals undergoing one-time opportunistic esophagogastroduodenoscopy (EGD) during colonoscopy within the organized colorectal cancer screening programme, and treatment costs from a retrospective cohort of 222 patients with gastric adenocarcinoma. Direct medical costs were analyzed according to disease stage and compared with two modeled early-stage management scenarios.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Gastric precancerous conditions were identified in 46.9% of screened individuals, and gastric adenocarcinoma was detected in 0.8% (3/377). The estimated screening cost was €17,249 per cancer detected. Mean treatment and follow-up costs per patient were €32,140 for Stage II disease, €33,073 for Stage III disease, and €19,287 for Stage IV disease. The estimated cumulative cost of screening followed by ESD was €27,624, whereas screening followed by surgical treatment of Stage I disease was estimated at €44,493.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>GC management is associated with substantial healthcare expenditure. The potential economic value of opportunistic GC screening is likely to depend on the detection of lesions amenable to endoscopic treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trail Registration</h3>\u0000 \u0000 <p>NCT07522320.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109097","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":"Epidemiology of Helicobacter pylori and Gastric Atrophy in Rural Southwestern Uganda: The ENIGMA Uganda Study","authors":"Yue Huang,&nbsp;Viktoria Knaze,&nbsp;Joseph Mugisha,&nbsp;Anne-Sophie Navionis,&nbsp;Sabina Rinaldi,&nbsp;Gary M. Clifford,&nbsp;Jin Young Park,&nbsp;Robert Newton","doi":"10.1111/hel.70163","DOIUrl":"10.1111/hel.70163","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Characterizing the epidemiology of <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection and gastric atrophy (GA) is essential for informing preventive strategies in anticipation of the rising gastric cancer burden. The International Agency for Research on Cancer has initiated global studies to characterize these epidemiological patterns using a standardized framework, including in Uganda.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This population-based study included 700 individuals aged 1–69 years, randomly selected from the General Population Cohort in rural Uganda, stratified by sex and age. Participants completed a structured questionnaire to assess risk factors related to <i>H. pylori</i> infection and GA, underwent anthropometric measurements, and provided blood samples. Anti-<i>H. pylori</i> IgG antibodies were measured using enzyme-linked immunosorbent assays (ELISA). In individuals aged ≥ 40 years, plasma pepsinogen I (PG I) and pepsinogen II (PG II) concentrations were measured by ELISA to define gastric atrophy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The age-standardized <i>H. pylori</i> seroprevalence was 76%. The crude seroprevalence was 63% in children aged 1–9 years, rose to over 80% in individuals aged 10–39 years, and then declined modestly in older age groups (73% in individuals aged ≥ 40). Men aged ≥ 40 years had a lower <i>H. pylori</i> seroprevalence compared to women aged ≥ 40 years (68% vs. 78%, <i>p</i> &lt; 0.05). Serologically defined GA was uncommon, with an overall prevalence of 6% (17/301; 95% CI: 3%–9%) among individuals aged ≥ 40 years. Obesity (aOR 6.0, 95% CI 1.6–20.9) and less than daily chili consumption (aOR 4.3, 95% CI 1.4–14.9) were associated with higher odds of GA among participants aged ≥ 40 years, after adjustment for age and sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this population-based study in rural southwestern Uganda, <i>H. pylori</i> infection was acquired early in life and was highly prevalent, whereas serologically defined gastric atrophy remained relatively uncommon. This distinct epidemiological pattern warrants further validation and investigation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109078","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":"Beyond Helicobacter pylori: Prevalence, Coinfection, and Clinicopathologic Patterns of Non-Helicobacter pylori Helicobacter (NHPH) in Human Gastric Biopsies","authors":"Daniel Vizenblit,&nbsp;Maya Azrad,&nbsp;Munir Nashashibi,&nbsp;Halim Roshrosh,&nbsp;Yaakov Maman,&nbsp;Avi Peretz","doi":"10.1111/hel.70165","DOIUrl":"10.1111/hel.70165","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Non-<i>Helicobacter pylori Helicobacter</i> (NHPH) species are increasingly recognized as human gastric colonizers, yet their prevalence, species distribution, and clinical significance remain incompletely defined, particularly in patient cohorts in the Middle East.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>In this retrospective study, 830 formalin-fixed paraffin-embedded gastric biopsy samples collected from patients undergoing esophagogastroduodenoscopy at Tzafon Medical Center, northern Israel, between 2022 and 2024 were subjected to species-specific PCR for <i>H. pylori</i> and NHPH species. Clinical, demographic, histopathological, and endoscopic data were correlated with PCR-defined infection status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p><i>H. pylori</i> was detected in 643/830 (77.5%), whereas at least one NHPH species was detected in 179 samples (21.6%). <i>H. bizzozeronii</i> was the predominant NHPH species, identified in 167/830 samples (20.1%), while <i>H. heilmannii</i>, <i>H. felis</i>, and <i>H</i>. <i>ailurogastricus</i> were rare (&lt; 1%), and <i>H. suis</i> and <i>H. salomonis</i> were not detected. Co-infection with <i>H. pylori</i> was common (18.2%), and was detected in 23.5% of all <i>H. pylori</i>-positive samples and 84.4% of NHPH-positive samples. NHPH prevalence was higher in females and demonstrated marked seasonality, peaking in autumn. Histopathological comparison showed a significant difference in foveolar hyperplasia rates across infection groups, with higher frequencies in NHPH-only and PCR detected negative for all species samples than in <i>H. pylori</i>-positive groups. In contrast, clinical symptoms and endoscopic findings were broadly comparable across infection strata.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings provide the first large-scale molecular characterization of gastric NHPH in Israel and show that NHPH, predominantly <i>H. bizzozeronii</i>, is relatively common in this population, is usually co-detected with <i>H. pylori</i>, and is associated more strongly with distinct epidemiologic and histopathologic patterns than with a distinct clinical or endoscopic phenotype.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13635466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109059","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":"Population-Level Trends in Gastric Cancer Mortality and Incidence After Expansion of Japanese National Health Insurance Coverage for Helicobacter pylori Eradication: A Descriptive Time-Trend Study","authors":"Masahiro Asaka,&nbsp;Tokuma Tanuma,&nbsp;Akiko Kowada,&nbsp;Shouji Matsushima,&nbsp;Kozo Akino","doi":"10.1111/hel.70162","DOIUrl":"https://doi.org/10.1111/hel.70162","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In February 2013, Japanese national health insurance coverage for <i>Helicobacter pylori</i> eradication was expanded to patients with <i>H. pylori</i>-positive, endoscopically diagnosed chronic gastritis. This policy broadened access to eradication treatment, but its relationship with subsequent population-level gastric cancer trends requires cautious interpretation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To describe national trends in gastric cancer mortality and incidence before and after the 2013 insurance expansion, with attention to age-specific patterns, endoscopic screening, treatment uptake, and alternative explanations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We examined publicly available national mortality data from the Ministry of Health, Labour and Welfare and cancer incidence data from the National Cancer Center. Calendar-year trends in annual gastric cancer deaths, incident cases, and age-specific deaths were evaluated descriptively. The 2013 policy change was treated as a major contextual event rather than as a causal intervention with an internally estimated counterfactual.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Annual gastric cancer deaths declined from 48,427 in 2013 to 37,394 in 2024, a 25.2% reduction in crude annual deaths. Incidence also decreased after a later peak, with available national incidence data showing fewer new cases by 2021. Age-specific analyses showed pronounced decreases in deaths among people younger than 80 years, whereas deaths among those aged 80 years or older continued to increase.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>After the 2013 expansion of insurance coverage for <i>H. pylori</i> eradication, gastric cancer mortality and incidence in Japan declined at the population level. These ecological trends are compatible with a contribution from increased eradication therapy and endoscopy-linked detection, but causality cannot be established from aggregate data alone. Age-standardized, claims-linked, stage-specific, and treatment-linked analyses are needed to quantify the independent policy effect.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70162","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148903971","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 Novel Helicobacter pylori Test Based on 16S rRNA Isothermal Amplification Point-of-Care Testing of Throat Swab","authors":"Ziyu Liu,&nbsp;Minqing Wu,&nbsp;Yanhong Li,&nbsp;Qiyu Huang,&nbsp;Zhiying Mao,&nbsp;Yong Diao,&nbsp;Huiyong Yang,&nbsp;Yuying Liu,&nbsp;Chuanbo Xie,&nbsp;Zhaoyan Yu","doi":"10.1111/hel.70164","DOIUrl":"https://doi.org/10.1111/hel.70164","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> (<i>H. pylori</i>) infection is a major risk factor for gastric cancer (GC) and other gastrointestinal diseases. Current non-invasive detection methods for <i>H. pylori</i>, such as ¹³C-urea breath test (UBT), are constrained by high cost, radiation concerns, prolonged test duration, and susceptibility to false negative results due to medication use. Thus, a rapid, cost-effective, accurate, and medication-resistant detection method for <i>H. pylori</i> infection is urgently needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This study developed a novel point-of-care testing for <i>H. pylori</i> infection based on 16S rRNA isothermal amplification, using throat swabs as the detection samples (POCT). To systematically evaluate its diagnostic performance, a multi-center cross-sectional paired diagnostic study was conducted at Shandong Public Health Clinical Center and East Campus of Qilu Hospital, Shandong University from January 2025 to August 2025. This study enrolled a total of 543 participants, all of whom underwent both POCT and UBT simultaneously on the same day. Regarding UBT as the reference gold standard, the diagnosis metrics including accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of POCT for <i>H. pylori</i> detection were analyzed to evaluate its clinical application.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The POCT assay exhibited an overall accuracy of 95%, sensitivity of 89%, and specificity of 97%. PPV and NPV were 90% and 96%, respectively. Its high agreement with UBT was confirmed by a Kappa value of 0.860 (<i>p</i> &lt; 0.01). Additionally, the diagnostic performance of POCT also demonstrated high consistency between two centers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The 16S rRNA isothermal amplification point-of-care testing exhibits excellent diagnostic accuracy for <i>H. pylori</i> infection. It holds the potential to serve as an economic, efficient, and widely applicable alternative to the traditional UBT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148903895","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":"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}