Skip to main content
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2000 Jun;54(6):444–450. doi: 10.1136/jech.54.6.444

Seroconversion and seroreversion in IgG antibodies to Helicobacter pylori: a serology based prospective cohort study

S Rosenstock 1, T Jorgensen 1, L Andersen 1, O Bonnevie 1
PMCID: PMC1731697  PMID: 10818120

Abstract

STUDY OBJECTIVES—To assess the incidence of seroconversion and seroreversion in IgG antibodies to Helicobacter pylori within a 11 year observation period using these events as markers for acquisition and loss of the infection, respectively.
DESIGN—Population based prospective cohort study
SETTING—Northern part of Copenhagen County, Denmark
PARTICIPANTS AND METHODS—A random sample of 2527 Danish adults were examined and blood obtained in 1983 and in 1994. Matching pairs of sera were analysed for the presence of IgG and IgM antibodies to H pylori with an in house enzyme linked immunosorbent assay. Participants who were seronegative at study entry and seropositive at follow up and had a fourfold increase in baseline IgG antibody levels were categorised as seroconverters and regarded as having acquired H pylori infection. Participants who were seropositive at study entry and had at least a fourfold decrease in baseline IgG antibody levels at follow up were assumed to have lost the infection (seroreverters).
RESULTS—The seroprevalence of H pylori infection was 24.7 (95% confidence intervals (95% CI) 23.0, 26.4) % in 1983 and 24.5 (95% CI 22.8, 26.2) % in 1994. A total of 14 participants seroconverted within the observation period (cumulative 11 year incidence proportion: 1.0 (95% CI 0.5, 1.5) %). Having increased IgM antibody levels at study entry significantly increased the likelihood of IgG seroconversion (relative risk 6.4 (95% CI 2.1, 19.6). Seroreversion was seen in 48 participants (cumulative 11 year incidence proportion: 7.7 (95% CI 5.6, 9.8) %).
CONCLUSIONS—Changes in H pylori infection status with time are rare in Danish adults. Few adults become infected with H pylori in Denmark.


Keywords: Helicobacter pylori; seroconversion; sero-reversion

Full Text

The Full Text of this article is available as a PDF (148.3 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andersen L. P., Espersen F., Souckova A., Sedlackova M., Soucek A. Isolation and preliminary evaluation of a low-molecular-mass antigen preparation for improved detection of Helicobacter pylori immunoglobulin G antibodies. Clin Diagn Lab Immunol. 1995 Mar;2(2):156–159. doi: 10.1128/cdli.2.2.156-159.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Andersen L. P., Kiilerick S., Pedersen G., Thoreson A. C., Jørgensen F., Rath J., Larsen N. E., Børup O., Krogfelt K., Scheibel J. An analysis of seven different methods to diagnose Helicobacter pylori infections. Scand J Gastroenterol. 1998 Jan;33(1):24–30. doi: 10.1080/00365529850166167. [DOI] [PubMed] [Google Scholar]
  3. Andersen L. P., Raskov H., Elsborg L., Holck S., Justesen T., Fischer Hansen B., Møller Nielsen C., Gaarslev K. Prevalence of antibodies against heat-stable antigens from Helicobacter pylori in patients with dyspeptic symptoms and normal persons. APMIS. 1992 Sep;100(9):779–789. [PubMed] [Google Scholar]
  4. Andersen L. P., Rosenstock S. J., Bonnevie O., Jørgensen T. Seroprevalence of immunoglobulin G, M, and A antibodies to Helicobacter pylori in an unselected Danish population. Am J Epidemiol. 1996 Jun 1;143(11):1157–1164. doi: 10.1093/oxfordjournals.aje.a008694. [DOI] [PubMed] [Google Scholar]
  5. Banatvala N., Mayo K., Megraud F., Jennings R., Deeks J. J., Feldman R. A. The cohort effect and Helicobacter pylori. J Infect Dis. 1993 Jul;168(1):219–221. doi: 10.1093/infdis/168.1.219. [DOI] [PubMed] [Google Scholar]
  6. Cockburn M., Cox B. The effect of measurement error on the determination of Helicobacter pylori prevalence. Epidemiology. 1997 Mar;8(2):205–209. doi: 10.1097/00001648-199703000-00015. [DOI] [PubMed] [Google Scholar]
  7. Cullen D. J., Collins B. J., Christiansen K. J., Epis J., Warren J. R., Surveyor I., Cullen K. J. When is Helicobacter pylori infection acquired? Gut. 1993 Dec;34(12):1681–1682. doi: 10.1136/gut.34.12.1681. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Cutler A. F., Havstad S., Ma C. K., Blaser M. J., Perez-Perez G. I., Schubert T. T. Accuracy of invasive and noninvasive tests to diagnose Helicobacter pylori infection. Gastroenterology. 1995 Jul;109(1):136–141. doi: 10.1016/0016-5085(95)90278-3. [DOI] [PubMed] [Google Scholar]
  9. Forman D., Newell D. G., Fullerton F., Yarnell J. W., Stacey A. R., Wald N., Sitas F. Association between infection with Helicobacter pylori and risk of gastric cancer: evidence from a prospective investigation. BMJ. 1991 Jun 1;302(6788):1302–1305. doi: 10.1136/bmj.302.6788.1302. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Gasbarrini G., Pretolani S., Bonvicini F., Gatto M. R., Tonelli E., Mégraud F., Mayo K., Ghironzi G., Giulianelli G., Grassi M. A population based study of Helicobacter pylori infection in a European country: the San Marino Study. Relations with gastrointestinal diseases. Gut. 1995 Jun;36(6):838–844. doi: 10.1136/gut.36.6.838. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Graham D. Y., Malaty H. M., Evans D. G., Evans D. J., Jr, Klein P. D., Adam E. Epidemiology of Helicobacter pylori in an asymptomatic population in the United States. Effect of age, race, and socioeconomic status. Gastroenterology. 1991 Jun;100(6):1495–1501. doi: 10.1016/0016-5085(91)90644-z. [DOI] [PubMed] [Google Scholar]
  12. Hirschl A. M., Rotter M. L. Serological tests for monitoring Helicobacter pylori eradication treatment. J Gastroenterol. 1996 Nov;31 (Suppl 9):33–36. [PubMed] [Google Scholar]
  13. Jensen A. K., Andersen L. P., Wachmann C. H. Evaluation of eight commercial kits for Helicobacter pylori IgG antibody detection. APMIS. 1993 Oct;101(10):795–801. [PubMed] [Google Scholar]
  14. Jørgensen T. Prevalence of gallstones in a Danish population. Am J Epidemiol. 1987 Nov;126(5):912–921. doi: 10.1093/oxfordjournals.aje.a114728. [DOI] [PubMed] [Google Scholar]
  15. Klein P. D., Gilman R. H., Leon-Barua R., Diaz F., Smith E. O., Graham D. Y. The epidemiology of Helicobacter pylori in Peruvian children between 6 and 30 months of age. Am J Gastroenterol. 1994 Dec;89(12):2196–2200. [PubMed] [Google Scholar]
  16. Kosunen T. U., Seppälä K., Sarna S., Sipponen P. Diagnostic value of decreasing IgG, IgA, and IgM antibody titres after eradication of Helicobacter pylori. Lancet. 1992 Apr 11;339(8798):893–895. doi: 10.1016/0140-6736(92)90929-w. [DOI] [PubMed] [Google Scholar]
  17. Kuipers E. J., Klinkenberg-Knol E. C., Vandenbroucke-Grauls C. M., Appelmelk B. J., Schenk B. E., Meuwissen S. G. Role of Helicobacter pylori in the pathogenesis of atrophic gastritis. Scand J Gastroenterol Suppl. 1997;223:28–34. [PubMed] [Google Scholar]
  18. Kuipers E. J., Peña A. S., van Kamp G., Uyterlinde A. M., Pals G., Pels N. F., Kurz-Pohlmann E., Meuwissen S. G. Seroconversion for Helicobacter pylori. Lancet. 1993 Aug 7;342(8867):328–331. doi: 10.1016/0140-6736(93)91473-y. [DOI] [PubMed] [Google Scholar]
  19. Mahalanabis D., Rahman M. M., Sarker S. A., Bardhan P. K., Hildebrand P., Beglinger C., Gyr K. Helicobacter pylori infection in the young in Bangladesh: prevalence, socioeconomic and nutritional aspects. Int J Epidemiol. 1996 Aug;25(4):894–898. doi: 10.1093/ije/25.4.894. [DOI] [PubMed] [Google Scholar]
  20. Malaty H. M., Graham D. Y. Importance of childhood socioeconomic status on the current prevalence of Helicobacter pylori infection. Gut. 1994 Jun;35(6):742–745. doi: 10.1136/gut.35.6.742. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Milne R., Logan R. P., Harwood D., Misiewicz J. J., Forman D. Helicobacter pylori and upper gastrointestinal disease: a survey of gastroenterologists in the United Kingdom. Gut. 1995 Sep;37(3):314–318. doi: 10.1136/gut.37.3.314. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Nomura A., Stemmermann G. N., Chyou P. H., Perez-Perez G. I., Blaser M. J. Helicobacter pylori infection and the risk for duodenal and gastric ulceration. Ann Intern Med. 1994 Jun 15;120(12):977–981. doi: 10.7326/0003-4819-120-12-199406150-00001. [DOI] [PubMed] [Google Scholar]
  23. Parsonnet J., Blaser M. J., Perez-Perez G. I., Hargrett-Bean N., Tauxe R. V. Symptoms and risk factors of Helicobacter pylori infection in a cohort of epidemiologists. Gastroenterology. 1992 Jan;102(1):41–46. doi: 10.1016/0016-5085(92)91782-y. [DOI] [PubMed] [Google Scholar]
  24. Parsonnet J., Friedman G. D., Vandersteen D. P., Chang Y., Vogelman J. H., Orentreich N., Sibley R. K. Helicobacter pylori infection and the risk of gastric carcinoma. N Engl J Med. 1991 Oct 17;325(16):1127–1131. doi: 10.1056/NEJM199110173251603. [DOI] [PubMed] [Google Scholar]
  25. Pearce D. C., Peach H. G., Farish S. J. Helicobacter pylori antibody titres in serum, plasma and successively thawed specimens: implications for epidemiological and clinical studies. J Clin Pathol. 1996 Dec;49(12):1017–1019. doi: 10.1136/jcp.49.12.1017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Rosenstock S. J., Jørgensen T. Prevalence and incidence of peptic ulcer disease in a Danish County--a prospective cohort study. Gut. 1995 Jun;36(6):819–824. doi: 10.1136/gut.36.6.819. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Rothenbacher D., Bode G., Adler G., Brenner H. Use of commonly prescribed antibiotics is not associated with prevalence of Helicobacter pylori infection in adults. Scand J Gastroenterol. 1997 Nov;32(11):1096–1099. doi: 10.3109/00365529709002987. [DOI] [PubMed] [Google Scholar]
  28. Sipponen P., Kosunen T. U., Samloff I. M., Heinonen O. P., Siurala M. Rate of Helicobacter pylori acquisition among Finnish adults: a fifteen year follow-up. Scand J Gastroenterol. 1996 Mar;31(3):229–232. doi: 10.3109/00365529609004871. [DOI] [PubMed] [Google Scholar]
  29. Sobala G. M., Crabtree J. E., Dixon M. F., Schorah C. J., Taylor J. D., Rathbone B. J., Heatley R. V., Axon A. T. Acute Helicobacter pylori infection: clinical features, local and systemic immune response, gastric mucosal histology, and gastric juice ascorbic acid concentrations. Gut. 1991 Nov;32(11):1415–1418. doi: 10.1136/gut.32.11.1415. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Vaira D., Holton J., Cairns S. R., Falzon M., Polydorou A., Dowsett J. F., Salmon P. R. Antibody titres to Campylobacter pylori after treatment for gastritis. BMJ. 1988 Aug 6;297(6645):397–397. doi: 10.1136/bmj.297.6645.397. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Vaira D., Miglioli M., Mulè P., Holton J., Menegatti M., Vergura M., Biasco G., Conte R., Logan R. P., Barbara L. Prevalence of peptic ulcer in Helicobacter pylori positive blood donors. Gut. 1994 Mar;35(3):309–312. doi: 10.1136/gut.35.3.309. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Valle J., Kekki M., Sipponen P., Ihamäki T., Siurala M. Long-term course and consequences of Helicobacter pylori gastritis. Results of a 32-year follow-up study. Scand J Gastroenterol. 1996 Jun;31(6):546–550. doi: 10.3109/00365529609009126. [DOI] [PubMed] [Google Scholar]
  33. Veenendaal R. A., Peña A. S., Meijer J. L., Endtz H. P., van der Est M. M., van Duijn W., Eulderink F., Kreuning J., Lamers C. B. Long term serological surveillance after treatment of Helicobacter pylori infection. Gut. 1991 Nov;32(11):1291–1294. doi: 10.1136/gut.32.11.1291. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Veldhuyzen van Zanten S. J., Pollak P. T., Best L. M., Bezanson G. S., Marrie T. Increasing prevalence of Helicobacter pylori infection with age: continuous risk of infection in adults rather than cohort effect. J Infect Dis. 1994 Feb;169(2):434–437. doi: 10.1093/infdis/169.2.434. [DOI] [PubMed] [Google Scholar]
  35. Veldhuyzen van Zanten S. J., Sherman P. M. Helicobacter pylori infection as a cause of gastritis, duodenal ulcer, gastric cancer and nonulcer dyspepsia: a systematic overview. CMAJ. 1994 Jan 15;150(2):177–185. [PMC free article] [PubMed] [Google Scholar]
  36. Webb P. M., Knight T., Greaves S., Wilson A., Newell D. G., Elder J., Forman D. Relation between infection with Helicobacter pylori and living conditions in childhood: evidence for person to person transmission in early life. BMJ. 1994 Mar 19;308(6931):750–753. doi: 10.1136/bmj.308.6931.750. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Xia H. H., Talley N. J. Natural acquisition and spontaneous elimination of Helicobacter pylori infection: clinical implications. Am J Gastroenterol. 1997 Oct;92(10):1780–1787. [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES