Objective: To study Helicobacter pylori seroepidemiology before and after orthotopic liver transplantation.
Methods: Serum samples obtained from 118 liver transplant recipients before and after transplantation were examined for the presence of IgG antibodies to H. pylori whole cell extract and to the CagA protein of H. pylori.
Results: Of 118 patients, 64 (54.2%) were H. pylori positive, and 36 (56.3%) of these had CagA antibodies. Of the 64 seropositive patients, 22 (34.4%) remained positive and 42 (65.6%) became negative for H. pylori antibodies a median of 39 months after transplantation. Patients who seroreverted showed a tendency to lower pretransplantation antibody levels and had received antibiotic therapy for at least 4 days. Seroreversion or antibody persistence was not affected by age, sex, CagA antibody status, CagA antibody titer, duration of antibiotic therapy, or immunosuppressive drugs administered after liver transplantation.
Conclusions: The prevalence of H. pylori infection, as detected by serological screening, in patients selected for liver transplantation is not different from that in the general population. In these patients, the seroprevalence of H. pylori drops after liver transplantation. This is largely due to the intake of antibiotics and immunosuppressants by transplant recipients. Seroreversion seems to be independent of the type of H. pylori bacteria.