22552
document
Long term follow up of patients treated for Helicobacter pylori infection . BACKGROUND Helicobacter pylori infection induces progressive inflammatory changes in the gastric mucosa that may lead to gastric cancer . Understanding long term effects resulting from the cure of this infection is needed to design cancer prevention strategies . METHODS A cohort of 795 adults with preneoplastic gastric lesions was randomised to receive anti-H pylori treatment and/or antioxidants . At the end of six years of intervention , those who did not receive anti-H pylori treatment were offered it . Gastric biopsies were obtained at baseline , and at 3 , 6 , and 12 years . A histopathology score was utilised to document changes in gastric lesions . Non-linear mixed models were used to estimate the cumulative effect of H pylori clearance on histopathology scores adjusted for follow up time , interventions , and confounders . RESULTS Ninety seven per cent of subjects were H pylori positive at baseline , and 53 % were positive at 12 years . Subjects accumulated 1703 person years free of infection . A multivariate model showed a significant regression in histopathology score as a function of the square of H pylori negative time . Subjects who were H pylori negative had 14.8 % more regression and 13.7 % less progression than patients who were positive at 12 years ( p = 0.001 ) . The rate of healing of gastric lesions occurred more rapidly as years free of infection accumulated , and was more pronounced in less advanced lesions . CONCLUSIONS Preneoplastic gastric lesions regress at a rate equal to the square of time in patients rendered free of H pylori infection . Our findings suggest that patients with preneoplastic gastric lesions should be treated and cured of their H pylori infection .
22553
Intervention_Pharmacological
receive anti-H pylori treatment and/or antioxidants
22554
Outcome_Physical
Helicobacter pylori infection .
22555
Outcome_Physical
inflammatory changes
22556
Outcome_Physical
histopathology score
22557
Outcome_Physical
gastric lesions .
22558
Outcome_Physical
H pylori
22559
Outcome_Physical
free of infection .
22560
Outcome_Physical
regression in histopathology score
22561
Outcome_Physical
H pylori negative time .
22562
Outcome_Physical
H pylori
22563
Outcome_Physical
regression
22564
Outcome_Physical
progression
22565
Outcome_Physical
rate of healing of gastric lesions
22566
Outcome_Adverse-effects
years free of infection
22567
Outcome_Physical
Preneoplastic gastric lesions
22568
Participant_Condition
Helicobacter pylori infection
22569
Participant_Sample-size
795
22570
Participant_Age
adults
22571
Participant_Condition
preneoplastic gastric lesions
22572
Participant_Condition
preneoplastic gastric lesions