Dynamics of Helicobacter pylori Detection in Stools During the First 5 Years of Life in Chile, a Rapidly Developing Country

Abstract

Background: Helicobacter pylori colonization/infection can be transitory or persistent, conditions that have not been thoroughly evaluated in young children. We aimed to characterize the dynamics of H. pylori stool detection and to determine host and environmental factors and symptoms associated with persistence. Method: In a 5-year cohort study, we followed-up infants from birth with clinic visits every 3 months. Symptoms and environmental risk factor survey and a stool sample for H. pylori antigen detection were requested in every visit. Secretor/ABH histo-blood group phenotype was determined in saliva. Results: Overall, 218 of 1456 (15%) stool samples were positive for H. pylori and 39 of 96 (41%) children had at least 1 positive sample. Stool detection was transitory in 16 of 39 (41%), persistent in 19 (49%) and undetermined in 4 (10%) children. Persistence was acquired largely during the first 24 months (17/19 cases) and was associated with nonsecretor phenotype (32% versus 0% for transitory infection; P = 0.02) and daycare attendance (67% versus 26% for never infected; P = 0.019). Symptoms possibly associated with persistence were referred in only 1 child. Conclusions: Nearly 20% of this Chilean cohort had persistent H. pylori stool sample detections during the first 5 years of life, acquired mostly during the first 24 months. Persistence was significantly associated with nonsecretor phenotype and daycare attendance, and possibly associated gastrointestinal symptoms were rare. This relatively common group of young children with persistent H. pylori colonization/infection will require further study.