Helicobacter最新文献

{"title":"Meta-analysis of Helicobacter pylori eradication therapy using vonoprazan as an acid suppressor compared with bismuth quadruple therapy","authors":"Hui Yang,&nbsp;Miao Zhang,&nbsp;Gang Ma,&nbsp;Jiaqi Yang,&nbsp;Kemei Wang,&nbsp;Shuangshuang Jiang,&nbsp;Jiaqiang Dong,&nbsp;Ying Han","doi":"10.1111/hel.13059","DOIUrl":"10.1111/hel.13059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Vonoprazan, a novel acid suppressant, has recently emerged as a regimen for eradicating <i>Helicobacter pylori</i>. However, uncertainties exist about the effectiveness and safety of VPZ-based regimens compared with those of bismuth-based quadruple therapy in eradicating <i>H. pylori</i>. The present meta-analysis was performed to compare the effectiveness and safety of vonoprazan-based regimens with those of bismuth quadruple therapy in eradicating <i>H. pylori</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>All randomized controlled trials and non-randomized controlled trials comparing the vonoprazan-based therapy with the bismuth quadruple therapy were included in this meta-analysis. Information was also extracted by two evaluators, and if heterogeneity existed, a random-effects model was used to calculate the combined relative ratio and 95% confidence interval; otherwise, a fixed-effects model was used. And subgroup analyses were performed to explore the sources of heterogeneity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 10 studies, comprising 2587 patients were included in the meta-analysis. The results showed that the combined eradication rate of patients treated with the vonoprazan-based regimen was significantly higher than that of patients treated with bismuth quadruple therapy, in both intention-to-treat and per-protocol analyses, and the differences were statistically significant. Among the intention-to-treat analyses results: (90.28% vs. 83.64% [odds ratio (OR) = 1.85, 95% confidence interval (CI) (1.27, 2.70), <i>p</i> = 0.001]); in the per-protocol analyses: (94.80% vs. 89.88%, [OR = 2.25, 95% CI (1.37, 3.69), <i>p</i> = 0.001]). The occurrence of adverse events was significantly lower in patients treated with vonoprazan-based regimens than in those treated with bismuth quadruple therapy, (14.50% vs. 25.89%, [OR = 0.49, 95% CI (0.32, 0.75), <i>p</i> = 0.001]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>For eradicating <i>H. pylori</i>, vonoprazan-based regimens are remarkably advantageous over bismuth quadruple therapy. Furthermore, vonoprazan-based regimens exhibit a lower rate of adverse events than bismuth quadruple therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 2","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140039204","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":"Primary antibiotic resistance of Helicobacter pylori in India over the past two decades: A systematic review","authors":"Spriha Dutta,&nbsp;Surbhi Jain,&nbsp;Kunal Das,&nbsp;Prashant Verma,&nbsp;Anup Som,&nbsp;Rajashree Das","doi":"10.1111/hel.13057","DOIUrl":"10.1111/hel.13057","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> antibiotic resistance has undergone vast changes in the last two decades. No systematic review has been done on the prevalence of antibiotic resistant <i>H. pylori</i> in India in the last two decades. We evaluated the pattern of resistance rates across various regions of India.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A systematic review of the geographical variations in antibiotic resistance pattern of <i>H. pylori</i> was conducted using PubMed, Google Scholar, Web of Science, Science Direct, etc. for articles published between January 1, 2000 and May 30, 2023. Random effects-model-based Cochran's Q test, <i>I</i>² statistics, and chi-squared tests were used to measure heterogeneity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall resistance was highest against metronidazole (77.65%) followed by amoxicillin (37.78%), levofloxacin (32.8%), clarithromycin (35.64%), furazolidone (12.03%), and tetracycline (11.63%). 14.7% of the <i>H. pylori</i> isolates were multi-drug resistant. Under meta-analysis of each antibiotic, high heterogeneity levels were observed having <i>I</i>² ranges from 86.53% to 97.70% at <i>p</i> &lt; 0.0001. In sub-group analysis, Metronidazole has a stable rate of resistance as compared to other antibiotics. Other antibiotics have had a downtrend in the last 5 years except for levofloxacin, which has had an uptrend in the resistance rate for the past 5 years. Hence, one should avoid using metronidazole for any kind of first-line treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Metronidazole resistance is high in most regions of India except Assam and Mumbai while clarithromycin is found to be ineffective in South India, Gujarat, and Kashmir. As compared to other antibiotics, resistance to amoxicillin is generally low except in certain regions (Hyderabad, Chennai, and the Gangetic belt of North India). Tetracycline and Furazolidone have the least resistance rates and should be part of anti- <i>H. pylori</i> regimens. The resurgence of high single and multidrug resistance to the commonly used drugs suggests the need for newer antibiotics and regular resistance surveillance studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982826","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":"A pilot study evaluating high dose esomeprazole, bismuth subcitrate and amoxicillin for eradicating Helicobacter pylori infection in Iran","authors":"Sepehr Tirgar Fakheri,&nbsp;Hajar Shokri-Afra,&nbsp;David Y. Graham,&nbsp;Zohreh Bari,&nbsp;Hafez Fakheri","doi":"10.1111/hel.13061","DOIUrl":"10.1111/hel.13061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> (<i>H. pylori</i>) is strongly associated with peptic ulcer disease and gastric cancer. We evaluated two triple therapy regimens comprising esomeprazole, high dose bismuth, and different doses of amoxicillin for first-line <i>H. pylori</i> eradication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Two hundred patients with dyspepsia and naive <i>H. pylori</i> infection were randomly assigned into two groups (<i>n</i> = 100). Both groups were treated for 14 days similarly with esomeprazole (40 mg, twice daily) and bismuth subcitrate (240 mg, three times daily), but the dose of amoxicillin was varied between Groups A (750 mg) and B (1000 mg) three times daily. Treatment compliance and side effect were evaluated following the therapies and after 8 weeks, a negative test of stool <i>H. pylori</i> antigen confirmed eradication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The two groups were comparable with respect to sex and age. According to intention to treat analysis, eradication rates were 80% (95% CI: 77.2%–82.8%) and 90% (95% CI: 84.1%–95.9%) in A and B groups, respectively (<i>p</i> = 0.22). Per-protocol eradication rates were 87% (95% CI: 80.4%–93.6%) and 92.8% (95% CI: 87.7%–97.9%), respectively (<i>p</i> = 0.23). Severe adverse effects were 3% and 2%, respectively (<i>p</i> = 0.34).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>High dose esomeprazole, amoxicillin and bismuth achieved 92.8% cure rates per protocol in a country with a high background rate of resistance. Additional studies are needed to ascertain whether this therapy can be further improved. Until then, it can be recommended as a first-line <i>H. pylori</i> eradication in north of Iran.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971717","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":"Comparison between the GastroPanel test and the serum pepsinogen assay interpreted with the ABC method—A prospective study","authors":"Sun-Young Lee,&nbsp;Yeon-Sun Ahn,&nbsp;Hee-Won Moon","doi":"10.1111/hel.13056","DOIUrl":"10.1111/hel.13056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>This study aimed to validate <i>Helicobacter pylori</i> serological and pepsinogen (PG) assays for detecting infection and gastric neoplasm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Individuals who underwent serum Chorus <i>H. pylori</i> and HBI PG assays were included from May to September 2023. The GastroPanel test was performed using the same blood sample. HBI assay findings were interpreted with the ABC method using the criteria of corpus atrophy (PG I ≤ 70 ng/mL &amp; I/II ≤3) and advanced corpus atrophy (PG I ≤ 30 ng/mL &amp; I/II ≤2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 144 <i>H. pylori-</i>infected and 184 non-infected Koreans were analyzed. The Chorus test (sensitivity 97.2%, specificity 89.1%) showed higher area under the curve (0.993 vs. 0.972, <i>p</i> = 0.003) than the GastroPanel test (sensitivity 95.8%, specificity 86.4%). Using the GastroSoft application, the incidence of gastric neoplasms was highest in the corpus atrophy group (50%), followed by the low acid-output (25.8%), <i>H. pylori</i> infection (11.6%), and antral atrophy (9.1%) groups. There were no gastric neoplasms in the normal and high acid output groups. Using the ABC method, the incidence of gastric neoplasms was highest in the corpus atrophy groups (23.8% in Groups C and D), followed by Group B (12.3%) and Group A (2.4%). Corpus atrophy interpreted with the GastroSoft showed poor agreement (<i>k</i> = 0.225) with corpus atrophy interpreted with the ABC method, whereas it showed excellent agreement (<i>k</i> = 0.854) with advanced corpus atrophy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although the Chorus test was more accurate than the GastroPanel test, both assays discriminated high-risk individuals by detecting atrophy or infection. There were no gastric neoplasms in the normal or high acid-output groups (GastroSoft application), and gastric neoplasm incidence was lowest in Group A (ABC method). Corpus atrophy determined by GastroSoft application is more consistent with advanced corpus atrophy determined by the ABC method than is corpus atrophy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.13056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139944120","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":"Helicobacter pylori antigens as immunomodulators of immune system","authors":"Zeynab Marzhoseyni,&nbsp;Mohammad Javad Mousavi,&nbsp;Somayeh Ghotloo","doi":"10.1111/hel.13058","DOIUrl":"10.1111/hel.13058","url":null,"abstract":"<p><i>Helicobacter pylori</i> (<i>H. pylori</i>) is one of the most prevalent human pathogens and the leading cause of chronic infection in almost half of the population in the world (~59%). The bacterium is a major leading cause of chronic gastritis, gastric and duodenal ulcers, and two type of malignancies, gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma. Despite the immune responses mounted by the host, the bacteria are not cleared from the body resulting in a chronic infection accompanied by a chronic inflammation. Herein, a review of the literature discussing <i>H. pylori</i> antigens modulating the immune responses is presented. The mechanisms that are involved in the modulation of innate immune response, include modulation of recognition by pattern recognition receptors (PRRs) such as modulation of recognition by toll like receptors (TLR)4 and TLR5, modulation of phagocytic function, and modulation of phagocytic killing mediated by reactive oxygen species (ROS) and nitric oxide (NO). On the other hands, <i>H. pylori</i> modulates acquired immune response by the induction of tolerogenic dendritic cells (DCs), modulation of apoptosis, induction of regulatory T cells, modulation of T helper (Th)1 response, and modulation of Th17 response.</p>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139912507","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":"Eradication rate and adherence with high-dose amoxicillin and proton pump inhibitor as first-line treatment for Helicobacter pylori infection: Experience from University Hospital in Chile","authors":"Christian von Muhlenbrock,&nbsp;Andrea Cordova,&nbsp;Paulina Nuñez,&nbsp;Nicole Pacheco,&nbsp;Karin Herrera,&nbsp;Rodrigo Quera","doi":"10.1111/hel.13052","DOIUrl":"10.1111/hel.13052","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In Chile, more than 70% of adults are infected by <i>Helicobacter pylori</i>. Clarithromycin should not be used in any regimen if there is &gt;15% resistance to this antibiotic, being greater than 26% in our population. In this scenario, the effectiveness of triple therapy (proton pump inhibitor [PPI], clarithromycin, amoxicillin) was only 63.8%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the eradication rate and safety of dual therapy (esomeprazole and amoxicillin) in high doses, through a prospective, observational, and descriptive study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with a positive urease test obtained in an upper digestive endoscopy were included. Any other previous <i>H. pylori</i> eradication regimen were excluded. All patients were treated with esomeprazole 40 mg three times a day and amoxicillin 750 mg four times a day for 14 days. The eradication rate of the dual therapy was evaluated with the <i>H</i>. <i>pylori</i> stool antigen test (the Pylori-Strip® test used) 6 weeks after completing the eradication treatment and with at least 14 days without PPI, being a negative result, confirmation of the effectiveness of this regimen.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 122 patients, 106 had a negative <i>H. pylori</i> antigen in stool; The intention-to-treat and per protocol analysis, the eradication rates were 91.8% [95% CI: 87%–97%] and 94% [95% CI: 90%–98%], respectively. Four patients discontinued treatment due to adverse effects. Smoking and adherence to treatment were associated with eradication rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this cohort of patients with <i>H. pylori</i> infection, high-dose dual therapy has a high eradication rate and good adherence, raising the possibility that it could be used as first-line therapy in our country. Studies with a larger number of patients should confirm these results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139706629","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":"Helicobacter hepaticus and Helicobacter bilis in liver and biliary cancers from ATBC and PLCO","authors":"Gwen Murphy,&nbsp;Neal D. Freedman,&nbsp;Christian C. Abnet,&nbsp;Demetrius Albanes,&nbsp;Amanda J. Cross,&nbsp;Wen-Yi Huang,&nbsp;Jill Koshiol,&nbsp;Katherine McGlynn,&nbsp;Dominick Parisi,&nbsp;Satu Männistö,&nbsp;Stephanie J. Weinstein,&nbsp;Tim Waterboer,&nbsp;Julia Butt","doi":"10.1111/hel.13053","DOIUrl":"10.1111/hel.13053","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter</i> species (spp.) have been detected in human bile and hepatobiliary tissue <i>Helicobacter</i> spp. promote gallstone formation and hepatobiliary tumors in laboratory studies, though it remains unclear whether <i>Helicobacter</i> spp. contribute to these cancers in humans. We used a multiplex panel to assess whether seropositivity to <i>Helicobacter (H.) hepaticus</i> or <i>H. bilis</i> proteins was associated with the development of hepatobiliary cancers in the Finnish Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study, and US-based Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included 62 biliary and 121 liver cancers, and 190 age-matched controls from ATBC and 74 biliary and 105 liver cancers, and 364 age- and sex-matched controls from PLCO. Seropositivity to 14 <i>H. hepaticus</i> and <i>H. bilis</i> antigens was measured using a multiplex assay. Odds ratios (ORs) and 95% confidence intervals (CIs) were adjusted for major hepatobiliary cancer risk factors and <i>Helicobacter pylori</i> serostatus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seropositivity to the <i>H</i>. <i>bilis antigen,</i> P167D, was associated with more than a twofold higher risk of liver cancer (OR: 2.38; 95% CI: 1.06, 5.36) and seropositivity to the <i>H</i>. <i>hepaticus</i> antigens HH0407 or HH1201, or <i>H. bilis</i> antigen, HRAG 01470 were associated with higher risk of biliary cancer (OR: 5.01; 95% CI: 1.53, 16.40; OR: 2.40; 95% CI: 1.00, 5.76; OR: 3.27; 95% CI: 1.14, 9.34, respectively) within PLCO. No associations for any of the <i>H</i>. <i>hepaticus or H</i>. <i>bilis</i> antigens were noted for liver or biliary cancers within ATBC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Further investigations in cohort studies should examine the role of <i>Helicobacter</i> spp. in the etiology of liver and biliary cancers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.13053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139706630","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":"Comparative analysis of large language models in medical counseling: A focus on Helicobacter pylori infection","authors":"Qing-Zhou Kong,&nbsp;Kun-Ping Ju,&nbsp;Meng Wan,&nbsp;Jing Liu,&nbsp;Xiao-Qi Wu,&nbsp;Yue-Yue Li,&nbsp;Xiu-Li Zuo,&nbsp;Yan-Qing Li","doi":"10.1111/hel.13055","DOIUrl":"https://doi.org/10.1111/hel.13055","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Large language models (LLMs) are promising medical counseling tools, but the reliability of responses remains unclear. We aimed to assess the feasibility of three popular LLMs as counseling tools for <i>Helicobacter pylori</i> infection in different counseling languages.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This study was conducted between November 20 and December 1, 2023. Three large language models (ChatGPT 4.0 [LLM1], ChatGPT 3.5 [LLM2], and ERNIE Bot 4.0 [LLM3]) were input 15 <i>H. pylori</i> related questions each, once in English and once in Chinese. Each chat was conducted using the “New Chat” function to avoid bias from correlation interference. Responses were recorded and blindly assigned to three reviewers for scoring on three established Likert scales: accuracy (ranged 1–6 point), completeness (ranged 1–3 point), and comprehensibility (ranged 1–3 point). The acceptable thresholds for the scales were set at a minimum of 4, 2, and 2, respectively. Final various source and interlanguage comparisons were made.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall mean (SD) accuracy score was 4.80 (1.02), while 1.82 (0.78) for completeness score and 2.90 (0.36) for comprehensibility score. The acceptable proportions for the accuracy, completeness, and comprehensibility of the responses were 90%, 45.6%, and 100%, respectively. The acceptable proportion of overall completeness score for English responses was better than for Chinese responses (<i>p</i> = 0.034). For accuracy, the English responses of LLM3 were better than the Chinese responses (<i>p</i> = 0.0055). As for completeness, the English responses of LLM1 was better than the Chinese responses (<i>p</i> = 0.0257). For comprehensibility, the English responses of LLM1 was better than the Chinese responses (<i>p</i> = 0.0496). No differences were found between the various LLMs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The LLMs responded satisfactorily to questions related to <i>H. pylori</i> infection. But further improving completeness and reliability, along with considering language nuances, is crucial for optimizing overall performance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139695343","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":"Low-dose or high-dose amoxicillin in vonoprazan-based dual therapy for Helicobacter pylori eradication? A systematic review and meta-analysis","authors":"Kun-Ping Ju,&nbsp;Qing-Zhou Kong,&nbsp;Yue-Yue Li,&nbsp;Yan-Qing Li","doi":"10.1111/hel.13054","DOIUrl":"https://doi.org/10.1111/hel.13054","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The amoxicillin dose used in dual therapy to eradicate <i>Helicobacter pylori</i> varies across studies and the optimal amoxicillin dose for vonoprazan-based dual therapies remains unclear. We aimed to investigate the efficacy and safety of low- and high-dose amoxicillin in vonoprazan–amoxicillin dual therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A comprehensive systematic review was conducted by searching databases from inception to October 2023. All trials that evaluated the effectiveness and safety of vonoprazan–amoxicillin dual therapy for eradicating <i>H. pylori</i> were included. Pooled eradication rate, incidence of adverse events, relative risks, and 95% confidence intervals are presented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighteen studies with 12 low-dose amoxicillin (VLA) and 13 high-dose amoxicillin (VHA) arms were included. The pooled eradication rates were 82.4% and 86.8% for VLA therapy, and 86.0% and 90.9% for VHA therapy by the intention-to-treat and per-protocol analyses, respectively. In the subgroup analysis stratified by duration, the eradication rates achieved in 7 days, 10 days, and 14 days treatments with VLA and VHA dual therapies were 80.8%, 84.2%, 83.1%, and 67.3%, 88.8%, 87.5%, respectively. In the four randomized controlled trials that directly compared VLA and VHA dual therapies, the efficacy was not statistically different in the intention-to-treat (76.9% vs 81.4%, <i>p</i> = 0.337) and per-protocol (81.6% vs 84.0%, <i>p</i> = 0.166) analyses. Additionally, the incidence of adverse events (<i>p</i> = 0.965) and compliance (<i>p</i> = 0.994) were similar in both groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>VLA therapy demonstrated comparable efficacy and safety to VHA therapy, along with regional differences. An appropriately extended treatment duration may be critical for therapeutic optimization of vonoprazan–amoxicillin treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139695181","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":"Machine learning models in predicting failure of Helicobacter pylori treatment: A two country validation study","authors":"Fang Jiang,&nbsp;Thomas K. L. Lui,&nbsp;Chengsheng Ju,&nbsp;Chuan-Guo Guo,&nbsp;Ka Shing Cheung,&nbsp;Wallis C. Y. Lau,&nbsp;Wai K. Leung","doi":"10.1111/hel.13051","DOIUrl":"10.1111/hel.13051","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The success rate of clarithromycin-containing <i>Helicobacter pylori</i> treatment had declined globally. This study aims to explore the role of different machine learning algorithms in predicting failure of <i>H. pylori</i> treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We included 84,609 adult patients who had received the first course of clarithromycin-containing triple therapy for <i>H. pylori</i> in Hong Kong from 2003 to 2013 as training set. Results were validated in patients who had received similar triple therapy with 27,736 Hong Kong patients between 2014 and 2017 (internal cohort); and 18,050 UK patients between 2012 and 2017 (external cohort). The performance of 11 available machine learning algorithms were used to predict the failure of triple therapy. The performance was determined by the area under receiver operating characteristic curve (AUC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The treatment failure rates in the training, internal and external validation cohort was 5.9%, 9.5%, and 6.1%, respectively. In the internal validation set, Extra-Tree (ET) Classifier had the best AUC (0.88; 95% CI, 0.87–0.88), sensitivity (79.6%; 95% CI, 79.0–80.2) and specificity (79.4%; 95% CI, 79.0–79.8). In the external validation set, ET Classifier also had the best AUC (0.85; 95% CI, 0.85–0.86), sensitivity (80.1%; 95% CI, 79.5–80.9), and specificity (80.2%; 95% CI, 78.8–81.3). Top features of importance used by ET Classifier in predicting treatment failure included time interval between antibiotic use and triple therapy (48.8%), age (29.1%) and triple therapy regime (6.28%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Machine learning algorithm, based on simple baseline clinical parameters, could help to identify patients at high risk of failure from clarithromycin-containing triple therapy for <i>H. pylori</i>.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.13051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139587656","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}