Reinfection after successful eradication of Helicobacter pylori in three different populations in Alaska

We performed a study to determine rates of reinfection in three groups followed for 2 years after successful treatment: American Indian/Alaska Native (AI/AN) persons living in urban (group 1) and rural (group 2) communities, and urban Alaska non-Native persons (group 3). We enrolled adults diagnosed with H. pylori infection based on a positive urea breath test (C-13-UBT). After successful treatment was documented at 2 months, we tested each patient by C-13-UBT at 4, 6, 12 and 24 months. At each visit, participants were asked about medication use, illnesses and risk factors for reinfection. We followed 229 persons for 2 years or until they became reinfected. H. pylori reinfection occurred in 36 persons; cumulative reinfection rates were 14.5%, 22.1%, and 12.0% for groups 1, 2, and 3, respectively. Study participants who became reinfected were more likely to have peptic ulcer disease (P=0.02), low education level (P=0.04), or have a higher proportion of household members infected with H. pylori compared to participants who did not become reinfected (P=0.03). Among all three groups, reinfection occurred at rates higher than those reported for other US populations (< 5% at 2 years); rural AI/AN individuals appear to be at highest risk for reinfection.