Prevalence, treatment outcomes, and factors associated with Helicobacter pylori infection in patients with dyspepsia

Introduction: Helicobacter pylori infection is among the most prevalent infectious diseases and a proven risk factor for gastric cancer. Alongside dyspepsia, it represents a rising global medical burden. Unsuccessful eradication of H. pylori infection imposed an imperative to determine risk factors and potential predictors that can be related to its prevalence and treatment outcome. Aim: The study aimed to assess the prevalence of H. pylori infection in dyspeptic patients, identify related factors, and evaluate the effectiveness of commonly prescribed treatment regimens. Material and methods: A retrospective study was conducted, including 324 patients with dyspeptic symptoms who presented to the gastroenterology outpatient unit at the University Clinical Center of Serbia. Diagnosis of H. pylori was made following upper endoscopy and histology. Socio-epidemiologic, clinical and laboratory data were analyzed. Results: The overall prevalence of H. pylori infection in patients with dyspepsia was 19.7%. Hematological comorbidities were more common in H. pylori-positive patients than in the overall sample (15.6% vs 8.1%, p=0.012). A significant negative correlation was found between H. pylori infection and TIBC levels (p<0.001). Duodenitis (37.5% vs. 26%, p<0.01), superficial chronic gastritis (71.9% vs. 25%, p<0.01), and nonspecific inflammation (73.4% vs 58.9%, p=0.01) were significant predictors of H. pylori infection. Overall H. pylori eradication rate was 88.4%. Most commonly prescribed regimen was quadruple clarithromycin/ amoxicillin/metronidazole therapy (45%), while pantoprazole was the most prescribed proton pump inhibitor (PPIs). Conclusion: A The prevalence of H. pylori infection was relatively low. Positive H.pylori status was more frequently observed in patients with hematological comorbidities, lower TIBC levels, duodenitis, chronic superficial gastritis, and nonspecific gastric mucosal inflammation. The overall eradication rate was satisfactory, with quadruple therapy being the most commonly prescribed regimen.