DIAGNOSIS OF HELICOBACTER PYLORI INFECTION

Helicobacter pylori induces persistent inflammation in the human stomach, yet only a minority of colonized persons develop peptic ulcer disease or gastric malignancy. Results from recent investigations have demonstrated that H. pylori isolates possess substantial phenotypic and genotypic diversity which leads to different host inflammatory responses that influence clinical outcome. Numerous studies are being published on diagnostic tests for H. pylori. The tendency is to favor noninvasive tests. The urea breath and stool antigen tests using monoclonal antibodies are applied in different types of patients, while serology is still a subject of interest. Invasive tests were the first to be applied to H. pylori detection and still remain the “gold standard”. In patients having underwent upper endoscopy, in order to obtain gastric biopsy specimens, diagnosis of H. pylori infection is achieved using histological and cultivation methods and urease tests. In order to get insight into virulence factors and macrolide susceptibility, the molecular methods (realtime PCR) have been developed. Knowing the mechanisms of H. pylori pathogenesis and specific interaction between pathogen and the host, which are dependent upon strain-specific bacterial factors and induced host effectors, helps to define colonized persons bearing the highest risk for disease, and enable physicians to use the most appropriate diagnostic testing and eradication therapy.