Oyin Adedipe, MD1, Frances Wang, MS1, HannahSofia Brown, MD1, Serach Patterson, 1, Priya Alagesan, MD2, Caroline Labriola, MD2, Nina Salama, PhD3, Meira Epplein, PhD1, Katherine Garman, MD1 1Duke University, Durham, NC; 2Duke University School of Medicine, Boston, MA; 3Fred Hutchinson Cancer Center, Seattle, WA Introduction: Helicobacter pylori (Hp) is the strongest known risk factor for gastric malignancy. Prevalence of Hp in the US is decreasing but remains a significant cause of morbidity. The American College of Gastroenterology guidelines recommend both treatment and post-treatment eradication testing. This study aimed to examine factors associated with lack of eradication testing and infection persistence despite testing. Methods: We retrospectively analyzed a cohort of patients diagnosed with Hp without gastric intestinal metaplasia during endoscopies performed at our institution from 2015-2019. Electronic medical records, including pathology and endoscopy reports, clinical notes, and medication records were extracted into a REDCap database with tissue-based cagA virulence factor testing (previously identified in 56% of this cohort). We compared patients’ characteristics at different points within the treatment pathway to determine factors associated with lack of eradication testing and Hp persistence. Results: There were 331 patients in the final racially balanced cohort, with the mean age of 56 years at index endoscopy with Hp diagnosis. Of these, 305 patients (92%) received Hp treatment after diagnosis. 158 (52%) of the 305 patients received eradication testing after treatment. Black patients were more likely to have been treated without eradication testing compared to White patients (57% vs 44%, p = 0.04). Of the 158 patients who underwent eradication testing, 132 (84%) successfully cleared the infection and 26 (17%) had evidence of persistent infection, which was associated with neither race nor with evidence of the cagA virulence factor. Of those with persistent infection, clarithromycin was less likely prescribed (39% vs 62%, p = 0.03) and metronidazole was more likely prescribed (65% vs 41%, p = 0.02). Discussion: The eradication testing rate in this cohort with Hp at endoscopy was 52%, with racial differences in receipt of eradication testing but not in treatment outcomes after eradication testing. Further, patients with evidence of cagA+ Hp had equally high treatment success as those without this virulence factor. While metronidazole is now suggested first-line treatment, treatment failures still occur, highlighting the importance of eradication testing. Our results demonstrate the need for rigorous follow-up care after Hp diagnosis across all groups.
Disclosures: Oyin Adedipe indicated no relevant financial relationships. Frances Wang indicated no relevant financial relationships. HannahSofia Brown indicated no relevant financial relationships. Serach Patterson indicated no relevant financial relationships. Priya Alagesan indicated no relevant financial relationships. Caroline Labriola indicated no relevant financial relationships. Nina Salama indicated no relevant financial relationships. Meira Epplein indicated no relevant financial relationships. Katherine Garman indicated no relevant financial relationships.
Oyin Adedipe, MD1, Frances Wang, MS1, HannahSofia Brown, MD1, Serach Patterson, 1, Priya Alagesan, MD2, Caroline Labriola, MD2, Nina Salama, PhD3, Meira Epplein, PhD1, Katherine Garman, MD1. P5568 - <i>Helicobacter pylori</i> Treatment: Retrospective Analysis of Factors That Are Associated With Eradication Testing and Infection Persistence, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
