P6321 - Screening and Eradication of Helicobacter pylori in a New York Community: Early Results From a Prospective Cohort

Syed Matthew Kodilinye, MBBS¹, Oluchi Ndulue, MBBS², Linda A.. Lee, MD, MBA³, Jessica Chung, MD², Anthony Kalloo, MBBS⁴, Sumitra Paudel, MBBS², Ming-Tuen Lam, MBBS², Yan Naing Tun, MBBS², Palvi Jindal, MBBS², Fizza Mohsin, MBBS², Khin Htet Htet Soe, MBBS², Jasveen Kaur, MBBS², Cherry Aye, MBBS², Wai Wai Mon, MBBS², Syed Mujtaba Baqir, MD², Zarif Kazi, MD², Laiz Darwich, MBBS², Khant Kaung Htet Lwin, MBBS², May Yee Lin, MBBS², Yu Shia Lin, MD²
1Stanford University, Palo Alto, CA; 2Maimonides Medical Center, Brooklyn, NY; 3Northwell Health, New Hyde Park, NY; 4Johns Hopkins University, Baltimore, MD

Introduction: Helicobacter pylori (HP) infection is a major risk factor for gastric cancer (GC), though infected individuals are often asymptomatic. Experts have proposed population-wide HP screening and eradication for GC prevention, but this strategy remains untested in the United States. We conducted an ongoing prospective “screen-and-treat” study in a New York community to assess HP prevalence, risk factors, and the utility of a novel serologic point-of-care test (nPOCT) that detects cytotoxin-associated gene A (CagA) and flagellar capping protein (FliD) antibodies for screening asymptomatic individuals.

Methods: Adults ≥18 years were invited to participate at primary care clinics in Brooklyn, NY. Demographics, history, and dyspepsia were assessed via questionnaires. All patients were tested with nPOCT, with positive results indicated by antibodies against CagA and/or FliD. All patients were ordered a stool antigen test (SAT) regardless of nPOCT results. Patients with positive SAT were offered treatment. Variables were compared with test results using Fisher's exact test. The test characteristics of nPOCT were compared with SAT.

Results: We analyzed data from patients enrolled from August 2024 to April 2025. The enrollment rate was 58%. Of the 133 patients enrolled, 51% were Hispanic/Latino, 23% Black, and 8% South Asian. 63% were 1st generation immigrants. 36% were seropositive for HP antibodies, which was associated with generational status (p=0.01).

Of the 65 patients who completed SAT, 31% tested positive for active infection on SAT. Most were 18-39 years old. 65% were 1st generation immigrants. 40% of HP-positive patients had dyspepsia, with epigastric burning the most frequent symptom. There was no personal or family history of HP or GC in almost all HP-positive patients. 50% of patients received quadruple therapy, and eradication was confirmed in 40% by repeat SAT.

Compared to SAT, the nPOCT demonstrated a negative predictive value (NPV) of 89% for ruling out active HP infection among asymptomatic patients.

Discussion: Our preliminary findings reveal >30% prevalence of HP in our urban clinic population. Screening of 1st generation immigrants from high-endemic regions should be prioritized. The nPOCT, with a NPV of 89%, shows potential as a rapid screening tool in a two-step testing strategy: positive nPOCT results can be confirmed with SAT, while negative results may not require further testing. Ongoing enrollment will help confirm these findings and support early HP detection to prevent GC.


Figure: Table 1 - Demographics, History, Symptoms, and Test Results


Figure: Table 2 - Test characteristics of nPOCT

Disclosures:
Syed Matthew Kodilinye indicated no relevant financial relationships.
Oluchi Ndulue indicated no relevant financial relationships.
Linda Lee: Enterra – Consultant, Clinical Events Committee (Safety) for ongoing clinical trial sponsored by this company.
Jessica Chung indicated no relevant financial relationships.
Anthony Kalloo indicated no relevant financial relationships.
Sumitra Paudel indicated no relevant financial relationships.
Ming-Tuen Lam indicated no relevant financial relationships.
Yan Naing Tun indicated no relevant financial relationships.
Palvi Jindal indicated no relevant financial relationships.
Fizza Mohsin indicated no relevant financial relationships.
Khin Htet Htet Soe indicated no relevant financial relationships.
Jasveen Kaur indicated no relevant financial relationships.
Cherry Aye indicated no relevant financial relationships.
Wai Wai Mon indicated no relevant financial relationships.
Syed Mujtaba Baqir indicated no relevant financial relationships.
Zarif Kazi indicated no relevant financial relationships.
Laiz Darwich indicated no relevant financial relationships.
Khant Kaung Htet Lwin indicated no relevant financial relationships.
May Yee Lin indicated no relevant financial relationships.
Yu Shia Lin indicated no relevant financial relationships.

Syed Matthew Kodilinye, MBBS¹, Oluchi Ndulue, MBBS², Linda A.. Lee, MD, MBA³, Jessica Chung, MD², Anthony Kalloo, MBBS⁴, Sumitra Paudel, MBBS², Ming-Tuen Lam, MBBS², Yan Naing Tun, MBBS², Palvi Jindal, MBBS², Fizza Mohsin, MBBS², Khin Htet Htet Soe, MBBS², Jasveen Kaur, MBBS², Cherry Aye, MBBS², Wai Wai Mon, MBBS², Syed Mujtaba Baqir, MD², Zarif Kazi, MD², Laiz Darwich, MBBS², Khant Kaung Htet Lwin, MBBS², May Yee Lin, MBBS², Yu Shia Lin, MD². P6321 - Screening and Eradication of <i>Helicobacter pylori</i> in a New York Community: Early Results From a Prospective Cohort, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.