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Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Feb 28, 2008; 14(8): 1231-1236
Published online Feb 28, 2008. doi: 10.3748/wjg.14.1231
Non-invasive diagnosis of H pylori infection: Evaluation of serological tests with and without current infection marker CIM
Sufi HZ Rahman, M Golam Azam, M Anisur Rahman, MS Arfin, M Mahbub Alam, Tareq M Bhuiyan, Nasim Ahmed, Motiur Rahman, Shamsun Nahar, MS Hassan
Sufi HZ Rahman, M Golam Azam, MS Hassan, Department of Immunology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh
M Anisur Rahman, MS Arfin, M Mahbub Alam, Tareq M Bhuiyan, Department of Gastrointestinal Hepatobiliary and Pancreatic Diseases, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh
Nasim Ahmed, Department of Pathology, Ibrahim Medical College, Dhaka, Bangladesh
Motiur Rahman, Shamsun Nahar, Laboratory Sciences Division, International Centre for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh
Authors contributions: Rahman SHZ, Hassan MS, Alam MM, and Rahman M participated in designing the research; Rahman SHZ, Azam MG, Arfin MS, Alam MM, Bhuiyan TM, Ahmed N, and Nahar S performed the clinical and laboratory work; Azam MG performed data analysis and interpretation; Rahman SHZ was involved in drafting the manuscript; Rahman MA, Hassan MS, and Ahmed N revised the manuscript critically; Hassan MS, Rahman MA, and Rahman M provided administrative and technical support. Hassan MS supervised the whole project.
Correspondence to: Sufi HZ Rahman, MBBS, MD, Clinical Pathologist, Department of Microbiology, Dhaka Medical College, Dhaka- 1000, Bangladesh. sufihannan@yahoo.com
Telephone: +88-2-9665518
Fax: +88-2-8615919
Received: September 4, 2007
Revised: December 4, 2007
Published online: February 28, 2008
Abstract

AIM: To evaluate the performance of commercially available immunochromatographic (ICT) and immunoblot tests covering the current infection marker CIM and conventional ELISA for the diagnosis of H pylori infection in adult dyspeptic patients.

METHODS: Consecutive non-treated dyspeptic patients undergoing diagnostic endoscopy were tested for H pylori infection by culture, rapid urease test, and histology of gastric biopsy specimens. Serum from 61 H pylori infected and 21 non-infected patients were tested for anti-H pylori IgG antibodies by commercial ELISA (AccuBindTM ELISA, Monobind, USA), ICT (Assure®H pylori Rapid Test, Genelabs Diagnostics, Singapore), and immunoblot (Helico Blot 2.1, Genelabs Diagnostics, Singapore) assays. ICT and immunoblot kits cover CIM among other parameters and their performance with and without CIM was evaluated separately.

RESULTS: Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of ELISA were 96.7%, 42.8%, 83.1%, 81.8%, and 82.9%, of ICT were 90.1%, 80.9%, 93.2%, 73.9%, and 87.8%, of ICT with CIM were 88.5%, 90.4%, 96.4%, 73.0%, and 89.0%, of immunoblot were 98.3%, 80.9%, 93.7%, 94.4%, and 93.9%, and of immunoblot with CIM were 98.3%, 90.4%, 96.7%, 95.0%, and 96.3%, respectively.

CONCLUSION: Immunoblot with CIM had the best performance. ICT with CIM was found to be more specific and accurate than the conventional ELISA and may be useful for non-invasive diagnosis of H pylori infection.

Keywords: H pylori, ELISA, Immunochromatographic test, Immunoblot, Current infection marker