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Helicobacter pylori Noninvasive Testing
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Helicobacter pylori Noninvasive Testing
, H. pylori IgG, H. pylori Serology, H. pylori ELISA
See Also
Urea Breath Test
H. pylori Stool Antigen
s (
HpSA
)
Indications
Dyspepsia
evaluation
Labs
First-Line
Helicobacter Pylori
tests
Urea Breath Test
Test Sensitivity
: 97%
Test Specificity
: 100%
Requires
Fastin
g for 6 hours, no PPI for 2 weeks before test, and expensive
Stool
monoclonal
Antigen
tests (enzyme immunoassay)
Test Sensitivity
: 92%
Test Specificity
: 94%
Most accurate, but more expensive than immunochromatography
Stool
monoclonal
Antigen
tests (Immunochromatography)
Test Sensitivity
: 69-87%
Test Specificity
: 87-93%
Variable reliability, but available for office based testing
Labs
Other
Helicobacter Pylori
Antibody
or
Antigen
testing
IgG testing may be positive for years after eradication
Indicated only for initial diagnosis
Not used to confirm
H. pylori
cure
Reference lab
Serology
(
ELISA
for H. pylori IgG)
Test Sensitivity
: 90-93%
Test Specificity
: 95-96%
Office-based lab whole blood
Serology
(
ELISA
for IgG)
Test Sensitivity
: 50-85%
Test Specificity
: 75-100%
Urine
ELISA
for H. pylori IgG
Test Sensitivity
: 70-96%
Test Specificity
: 77-85%
Saliva
ELISA
for H. pylori IgG
Test Sensitivity
: 82-91%
Test Specificity
: 71-85%
Other Testing
String Test
Mechanism
Polymer string is swallowed
String is recovered and run for PCR or culture
Accuracy
Test Sensitivity
: 75-80%
Test Specificity
: 75-100%
Advantages
Noninvasive procedure
Disadvantages
Tests do not confirm cure after
H. pylori
management
Cure confirmation is only by the following tests
Urea Breath Test
H. pylori Stool Antigen
(
HpSA
)
Endoscopic Biopsy for H. pylori
References
Calvet (2009) Clin Infect Dis 48(10): 1385-91 +PMID:19368506 [PubMed]
Hahn (2000) Gastrointest Endosc 52(1):20-6 [PubMed]
Ho (2000) Gastroenterol Clin North Am 29(4):853-62 [PubMed]
Meurer (2002) Am Fam Physician 65(7):1327-39 [PubMed]
Snyder (1999) Can J Gastroenterol 13:585-9 [PubMed]
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