Seroepidemiology of Helicobacter pylori and

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Clinical Infectious Diseases    2003;37:1067-1072
© 2003 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2003/3708-0010$15.00
MAJOR ARTICLE


Seroepidemiology of Helicobacter pylori and Hepatitis A Virus and the Mode
of Transmission of Infection: A 9-Year Cohort Study in Rural Japan

Hoda M. Malaty,1 Eiji Tanaka,2 Toshiko Kumagai,3 Hiroyoshi Ota,3 Kendo
Kiyosawa,2 David Y. Graham,1,4 and Tsutomu Katsuyama3

1Department of Medicine and 4Division of Molecular Virology, Veterans
Affairs Medical Center and Baylor College of Medicine, Houston, Texas; and
2Second Department of Internal Medicine and 3Laboratory Medicine, Shinshu
University School of Medicine, Matsumoto, Japan



We compared the seroepidemiologic patterns of Helicobacter pylori and
hepatitis A virus (HAV) infections among participants in 2 independent
cross-sectional studies conducted in Japan in 1986 and 1994. Subgroups were
monitored with successive blood sampling. H. pylori and HAV infection status
was defined by results of enzyme-linked immunosorbent assay. In 1986, the
prevalence of H. pylori infection and HAV infection, respectively, were 80%
and 70% among adults and 31% and 5% among children. The prevalence of both
infections increased with age. Concordant infections were found in 74.5% of
adults ( = 0.2) versus 2% of children ( = 0.05). During the 9-year study
period, the incidence of H. pylori infection was 1.1% among adults and 2%
among children. The seroprevalence of HAV remained constant. The disparity
between the increase in prevalence of H. pylori and HAV infection with age
is likely associated with improvements in hygienic practices. The
discordance between the presence of the infections among younger persons is
evidence against a common source and/or vehicle for transmission.
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Received 3 February 2003; accepted 12 June 2003; electronicallypublished 23 September 2003.