Association of H. Pylori antibody Titer With Stool Antigen Test forDiagnosis of H. Pylori Infection in Patients with Dyspepsia.

Abstract

Background: Helicobacter pylori infection remains a major public health concern in Bangladesh. Although serology is no longer recommended as a first-line diagnostic tool, it is still widely used in Bangladesh, leading to potential over-diagnosis and unnecessary treatment. The diagnostic utility of high antibody titers, however remains uncertain. In this context, it is unclear whether the antibody test should be
abandoned or selectively used.

Objective: To assess the association between anti-H. pylori antibody titers and Stool Antigen Test for diagnosis of H. Pylori infection.

Methods: This cross-sectional observational study was conducted in the Department of Gastroenterology, BMU, from January to December
2024. A total of 125 dyspeptic patients were consecutively enrolled. Demographic, clinical, and laboratory data were analyzed. Stool
Antigen Test and anti-H. pylori IgG (IMMULITE® 2000) were performed.

Results: The mean age of participants was 38.9 years; 62.6% were female. Stool Antigen Test was positive in 40.8% of patients, while IgG seropositivity was observed in 72%. Only patients with titers ≥3.0 U/mL showed a significant association with stool antigen positivity (p < 0.01). Correlation between anti-H. pylori antibody titers and Stool Antigen Test was weak (r = 0.53) and agreement between tests was fair (κ = 0.22).
Conclusion: The antibody test has limited diagnostic reliability when used alone and confirmatory testing with definite methods remains
necessary for detection of H pylori infection in clinical practice.