Recurrence Rate and Influencing Factors of Helicobacter Pylori Infection After Successful Eradication in Southern Coastal China

Daya Zhang,1,&ast; Fen-jiao Mao,1,&ast; Shimei Huang,1,&ast; Chen Chen,1 Da Li,1 Fan Zeng,1 Feihu Bai2,3 1Graduate School, Hainan Medical University, Haikou, People’s Republic of China; 2Department of Gastroenterology, The Second Affiliated Hospital of Hainan Medical University, Haikou, People’s Republic of China; 3The Gastroenterology Clinical Medical Center of Hainan Province, Haikou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Feihu Bai, Chief Physician and Professor of the Department of Gastroenterology, The Second Affiliated Hospital of Hainan Medical University, Yehai Avenue, &num;368, Longhua District, Haikou, Hainan Province, People’s Republic of China, Tel +86-18995181963, Fax +86-89866809168, Email baifeihu_hy@163.comPurpose: Recurrence rate of Helicobacter pylori (H. pylori) infection after successful eradication have gained attention. This study was to assess the recurrence rate of H. pylori infection after successful eradication in the southern coastal provinces of China and to analyze its factors.Patients and Methods: 975 patients with upper gastrointestinal symptoms who were diagnosed with H. pylori infection using the 13C or 14C-urea breath test (UBT) underwent eradication treatment between August 2021 and December 2022. After eight to twelve weeks, repeat UBT was performed. Besides, 824 patients with successful eradication underwent a repeat UBT by completing questionnaires after a year. The 1-year recurrence rate was calculated, and the differences were analyzed based on baseline data, sociological characteristics, and lifestyle.Results: A total of 734 patients completed the 1-year follow-up, out of which 26 (3.5%) patients experienced a recurrence of H. pylori infection. Exposure to other individuals infected with H. pylori (χ2=12.852, P< 0.001), poor hygiene conditions at dining out places (χ2=6.839, P=0.009), frequent dining out (χ2=24.315, P< 0.001), smoking (χ2=7.510, P=0.006), consumption of non-purified water (χ2=16.437, P< 0.001), consumption of pickled foods (χ2=5.682, P=0.017), irregular meal patterns (χ2=16.877, P< 0.001) and age (χ2=9.195, P=0.010) were significant factors for H. pylori infection recurrence. Exposure to other individuals infected with H. pylori, poor hygiene conditions at dining out places, consumption of non-purified water, frequent dining out and irregular meal patterns were independent risk factors (P=0.022, 0.016, 0.002, < 0.001, < 0.001; 95% CI 0.146– 0.861, 0.121– 0.806, 1.715– 10.845, 0.085– 0.521, 2.291– 14.556).Conclusion: The one-year recurrence rate of H. pylori infection post-eradication in the southern coastal provinces of China is 3.5%. Contacting with infected individuals, poor hygiene in dining places, consumption of non-purified water, frequent dining out, and irregular meal patterns were identified as significant independent factors influencing H. pylori recurrence.Keywords: Helicobacter pylori, successful eradication, Southern Coastal Provinces of China, risk factors, 1-year follow-up