Alimentary Tract B test is very reliable for diagnosis of Helicobacter pylori infection in real clinical practice

Aims. To determine the accuracy of the most common available tests for the diagnosis of Helicobacter pylori infection in an unselected and untreated population of patients. Patients and methods. Prospective study including 314 unselected patients from a population of 814 patients referred for upper 13 endoscopy at one hospital. H. pylori infection was diagnosed by rapid urease test (RUT), histology, culture and C-urea-breath test (UBT) and serum IgG (EIA). H. pylori infection was defined as positive if culture or at least two of the other tests were positive. Results. The prevalence of H. pylori infection in this population was 72%. The diagnostic test with the greatest combination of sensitivity (97%) and specificity (100%) was the UBT. EIA had a good sensitivity (96%), but it was the test with the least specificity (71%). RUT, histology and culture showed a high specificity ( .98%) but a sensitivity lower than 90%. In elderly patients ( .65 years old, n5120), UBT was also the test with the greatest combination of sensitivity (94%) and specificity (100%). 13 Conclusions. In conditions of real clinical practice the C-urea-breath test is a reliable test for H. pylori diagnosis, both in young and elderly patients.  2003 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.