Dynamics of Helicobacter pylori infection in early childhood in a high-risk group living in Germany: loss of infection higher than acquisition.

Background: The dynamics of Helicobacter pylori infection in early childhood are not yet well understood.

Aim: To conduct a prospective study in a population of children known to be at high risk of H. pylori infection to elucidate the incidence and loss of infection in childhood.

Methods: Asymptomatic Turkish children [aged 1 (n = 56 children), 2 (n = 55 children) and 4 years (n = 69 children)] at baseline, on whom participating paediatricians had performed routine health screening examinations between September 1997 and October 1998, were included in the study. A follow-up was performed about 1 year later. The infection status was defined by means of an antigen-based stool assay.

Results: In total, for 137 of 180 (76%) children, follow-up information was available. At baseline examination, the prevalence of infection in children with follow-up information was 27%[95% confidence interval (CI), 20-35%]. The incidence of H. pylori infection among previously uninfected children was 7% (95% CI, 3-14%) and the loss of infection among previously infected children was 35% (95% CI, 20-54%) during follow-up.

Conclusions: This prospective cohort study in a high-risk group of children living in Germany showed that H. pylori colonization may often not persist at an early age. Furthermore, the use of penicillins and macrolides may be associated with the loss of infection at an early age.