Prevalence of Helicobacter pylori in a private practice setting in Lima, Peru. Sensitivity of biopsies and rapid urease test

The prevalence of Helicobacter pylori in high and mid social-economic classes in Peru is trending down. This prevalence has not been evaluated at our institution in several years. The sensitivity of biopsies of the different anatomic areas of the stomach has not been evaluated either. Biopsies were taken from the antrum and body of the stomach for histologic evaluation. Biopsies were taken, one each, from body and antrum and were processed in the same sample for rapid urease test,(HpTest). HP infected patients were defined as those who had any of the three samples positive. Other variables evaluated were prior exposure to proton pump inhibitors, HP treatment, any other antibiotics, or bismuth subsalicylate. The overall prevalence of HP was 38.54%. It was 44.04% in those not exposed to the evaluated variables. Independent sensitivities were HpTest:84.46%, 89.86%.Sensitivities for antral and body biopsies were 64.86% and 79.73%, respectively. Exposure to proton pump inhibitors diminished the sensitivity of antral biopsies to 44%. This is the lowest reported incidence of HP in Peru. This is clearly associated with the social economic class using our facilities. Antral biopsies have a low sensitivity, which is even lower with prior exposure to proton pump inhibitors. It is not recommended to use antral biopsies exclusively to diagnose HP infection. Key Words: Helicobacter Pylori, incidence, gastric biopsy.