Background: The non-invasive Helicobacter pylori antibody (Hp Ab) test is convenient, cost-effective, and helpful for early detection and treatment.

Objective: To evaluate the accuracy of Hp Ab test for the diagnosis of Hp infection compared with the rapid urease test (RUT) and histology via Esophago-gastro-duodenoscopy (EGD).

Materials and Methods: Uninvestigated dyspeptic patients 18 to 80 years-old without contra-indicated to EGD were included in this study. On EGD day, all patients had received Hp Ab testing via blood and gastric biopsy sample via EGD for RUT and histological examination. Patients were considered Hp positive if one of the two invasive tests, either RUT or histology, was positive.

Results: Among the 269 patients, female were more predominant with mean age 55.2±14.8 years. The endoscopic findings were gastritis at 85.9%, gastric ulcer at 13.8%, duodenal ulcer at 7.1%, normal finding at 3.7%, and no gastric cancer. The prevalence of Hp infection was 40.1%. The diagnostic indices of Hp Ab test were sensitivity at 81.5%, specificity at 75.2%, positive predictive value at 68.8%, negative predictive value at 85.8%, and accuracy at 77.7%.

Conclusion: The Hp Ab testing is accurate for the diagnosis of Hp infection in uninvestigated dyspeptic patients. Positive cases can receive Hp eradication without EGD. In the negative cases, they should undergo EGD to determine the cause of dyspepsia.

Keywords: Uninvestigated dyspepsia; Helicobacter pylori; H. pylori antibody test; Rapid urease test; Histology; Gastroscopy

DOI: 10.35755/jmedassocthai.2022.08.13476

Received 5 January 2022 | Revised 8 June 2022 | Accepted 23 June 2022