Research report
Seroconversion and seroreversion in IgG antibodies to
Helicobacter pylori: a serology based
prospective cohort study
Steffen Rosenstocka, Torben Jørgensena, Leif Andersenb, Olaf Bonneviec
a Copenhagen
County Centre of Preventive Medicine, Glostrup University Hospital,
Glostrup, Denmark, b Department of Clinical Microbiology,
Rigshospitalet, Copenhagen, Denmark, c Department of Medicine I, Bispebjerg Hospital,
Copenhagen, Denmark
Correspondence to: Dr Rosenstock, Department of Surgery A, Centralsygehuset Hillerød, Helsevej 2, 3400 Hillerød, Denmark (e-mail: rosenstock.s{at}dadlnet.dk)
Accepted for publication 29 September 1999
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.
DESIGNPopulation
based prospective cohort study
SETTINGNorthern part
of Copenhagen County, Denmark
PARTICIPANTS AND
METHODSA 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).
RESULTSThe
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) %).
CONCLUSIONSChanges 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
© 2000 by Journal of Epidemiology and Community Health
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