Overview of Helicobacter pylori Infection, Prevalence, Risk Factors, and Its Prevention

Table 2

Diagnosis of H. pylori.

Methods	Sensitivity, specificity, pros	Cons	References
Invasive tests			[1, 85]
Endoscopy	>95% definitive diagnosis	Time-consuming, needs special skill
Histology	>95% gold standard	Observer dependency, high cost
Culture biopsy	>95% alternative gold standard	Expensive, complicated
Rapid urease test	>90% cost-effective and rapid test	Sensitivity specificity is low in gastric bleeding and intestinal metaplasia
Noninvasive tests			[1, 85]
Urea breath test	>95% simple, safe detection of eradication of infection	False-negative findings in case of bleeding and antibiotic use; less accurate in intestinal metaplasia, atrophic gastritis, and gastric cancer
Fecal antigen test	>90% simple, fast, inexpensive	False-negative results with the use of PPI, bismuth, antibiotics, and low bacterial load; the problem of keeping and carrying sample
Serology	80–90% cost-effective, applicable for patients treated with antibiotics and PPI, used for epidemiological studies	Insufficient reliability for routine screening, cannot distinguish between ongoing infection and previous contact, not applicable for confirming cure after therapy