Prevalence of Helicobacter pylori infection detected by serology and 13C-urea breath test in HIV-1 perinatally infected children

Background: Conflicting results have been reported in adults with human immunodeficiency virus (HIV-1) who were investigated for Helicobacter pylori infection. Most studies indicate a lower prevalence than is found in the general population. The purposes of this study were to evaluate H, pylori prevalence by noninvasive methods in a population of children perinatally infected with HIV-1 and to correlate H. pylori prevalence with HIV-1-related clinical and immunologic status. Methods: H. pylori infection was studied in 45 children perinatally infected with HIV-1 by performing serologic testing of anti-H. pylori immunoglobulin G antibodies and the C-13-urea breath test. Results: Eight children with HIV-1 (17.7%) were positive by serology, and nine (20%) were positive by C-13-urea breath test. No significant differences related to age, previous antibiotic treatment, immunoglobulin administration, antiretroviral treat-ment, abdominal pain, CD4+ cell count, number of HIV-1 RNA copies, and frequency of severe immunodepression were noted between children with positive C-13-urea breath test results and those with negative results. Children with positive results were significantly more likely to have severe clinical manifestations. Conclusions: The results show, by both serology and C-13-urea breath test, a prevalence of H. pylori infection comparable with the prevalence in the normal population of the same age. H. pylori prevalence has probably been underestimated in patients with HIV. Results of serologic and histologic analyses for H. pylori require cautious interpretation, especially in severely immunodeficient patients.