The frequency of Helicobacter pylori recurrence and reinfection after eradication scheme of first line with immunomodulator based on probiotic as adjuvant therapy: the five-year prospective study

Konorev M.R., Andronova T.M., Matveenko M.E.

Vitebsk State Medical University, Vitebsk, Belarus

The frequency of Helicobacter pylori recurrence and reinfection within five years after successful triple anti Helicobacter pylori therapy was determined. Successful eradication therapy was carried out at 118 patients with duodenal ulcer associated with H.pylori (middle age 44.1 ± 13.5 years, ratio of men and women - 84/34). Diagnostics of H.pylori in the gastric mucosa were carried out by Giemsa and rapid urease test (Jatrox®-H.p.-Test, Rohm Pharma, Germany; HELPYL®-test AMA, Russia) before treatment, 1.5-2 months, 6-8 months, 1 year, 2 years, 5 years after the ending of treatment and a cancellation of all drugs. All patients have been divided into 4 groups, according to the actual receipt of the protocol treatment (per protocol): omeprazole 0.02 g + clarithromycin 0.5 g + amoxicillin 1.0 g BID, within 7 days (ОCА7; n=29) and 14 days (ОCА14; n=29); omeprazole 0.02 g + clarithromycin 0.5 g + amoxicillin 1.0 g BID within 7 days, and Licopid 0.001 g QD (ОCА7L1; n=30) or 0.01 g QD (ОCА7L10; n=25) within 10 days. Completeness of tracking up to 2 years was 95.8% (n = 113), from 2 to 5 years – 85.6% (n = 101). Recurrence of H.pylori infection across 6-8 months after treatment (per protocol): OCA7 – 6.9% (n = 2), OCA14 – 3.4% (n = 1), OCA7L1 and OCA7L10 – 0%. Recurrence of H.pylori infection across 1 year after treatment (per protocol): OCA7 – 13.8% (n = 4), OCA14 – 3.4% (n = 1), OCA7L1 and OCA7L10 – 0%. The frequency of H.pylori reinfection across 2 years after treatment (per protocol): OCA7 - 32.0% (95% CI: 13.3-50.7%; n = 8), OCA14 - 10.7% (95% CI: 0.01-22.4%; n = 3), OCA7L1 - 3.3% (95% CI: 0.01-9.8%; n = 1), OCA7L10 - 4.0% (95% CI: 0.01-11.8%; n = 1). The frequency of H.pylori reinfection across 5 years after treatment (per protocol): OCA7 - 40.0% (95% CI: 20.4-59.6%; n = 10), OCA14 - 17.9% (95% CI: 3.4-32.4%; n = 5), OCA7L1 - 3.3% (95% CI: 0.01-9.8%; n = 1), OCA7L10 - 4.0% (95% CI: 0.01-11.8%; n = 1). Admission of Likopid 0.001 g QD and 0.01 g QD during the 7-day triple anti Helicobacter pylori therapy of first line leads to a lack of recurrence of H.pylori infection compared with 7 and 14-day treatment protocols without Likopid (N-acetylglucosaminyl-N-acetylmuramyl dipeptide) and significantly lower (P<0.01) the frequency of H.pylori reinfection within 2-5 years after treatment, compared to the 7-day protocol without adjuvant therapy of immunomodulator.