Estimation ofprevalence ofHelicobacter pylori infection inanasymptomatic elderly population comparing (14C) ureabreath testandserology

A non-invasive serological assaydevised inthislaboratory hada sensitivity and specificity of100%asdetermined bycultureandconfirmed byhistology ina groupof47patients whohadundergone endoscopy. The correlation between serology and the non-invasive [14C] breath testwasverygood. Onlyoneof24 culture positive patients was,whileall23 culture negative patients were,breath testnegative. Ina groupof46healthy elderly persons,however,significant anomalies betweenserology andbreath testwere observed. Only83% ofthe breath testnegative persons wereseronegative, whileonly68%ofthebreath test positive persons wereseropositive. These results canbeexplained intermsofage related atrophic gastritis andimmune incompetence, causing reduced colonisationanddecreased antibody production, respectively. Theseinvestigations suggest thatnoninvasive testsforH pylori infection may notbereliable intheelderly.