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Clinical and Diagnostic Laboratory Immunology, May 2004, p. 569-576, Vol. 11, No. 3
1071-412X/04/$08.00+0     DOI: 10.1128/CDLI.11.3.569-576.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Comparison of Different Criteria for Interpretation of Immunoglobulin G Immunoblotting Results for Diagnosis of Helicobacter pylori Infection

Philipp M. Lepper,1,2* Angelika Möricke,1 Konstanze Vogt,3 Günter Bode,4 and Matthias Trautmann1,{dagger}

Department of Medical Microbiology and Hygiene,1 Department of Epidemiology,4 Second Department of Internal Medicine II, University of Ulm, Ulm,2 Institute of Medical Microbiology, Charité, Humboldt University, Berlin, Germany3

Received 27 June 2003/ Returned for modification 6 January 2004/ Accepted 28 February 2004

Gastric infection with Helicobacter pylori is one of the most common chronic infections in humans, causing substantial morbidity and mortality. The diagnosis of H. pylori infection usually involves upper endoscopy with biopsy since the only noninvasive method of comparable accuracy, the [13C]urea breath test, requires technical equipment that is not available in most gastroenterological units. Serological methods for detection of H. pylori infection have reached sufficient accuracy to be used as screening tests before endoscopy or for seroepidemiological surveys. In the present study we evaluated different interpretation criteria for use with immunoglobulin G immunoblotting for the diagnosis of H. pylori infection. We applied five different sets of interpretation criteria, four of which had been published previously, to the Western blot results of 294 patients with different gastrointestinal symptoms. Since it is known that less than 2% of patients who are infected with H. pylori fail to seroconvert, an optimally sensitive Western blotting system should be able to detect approximately 98% of active infections. When the different criteria were applied to our patient population, it became apparent that the abilities of the systems to detect active H. pylori infection were quite varied. The results for the sensitivity and specificity, according to the different applied criteria, ranged from 62.8 to 95.9% and from 85.7 to 100.0%, respectively. Positive predictive values and negative predictive values, according to the published criteria, ranged from 97.2 to 100.0% and from 37.7 to 82.4%, respectively. Recommendations for the optimal use of the different interpretation criteria are discussed.

* Corresponding author. Mailing address: Department of Internal Medicine II, University of Ulm, Robert-Koch-Str. 8, 89081 Ulm, Germany. Phone: 49 731 500 40393. Fax: 49 731 500 24521. E-mail: philipp.lepper{at}medizin.uni-ulm.de.

{dagger} Present address: Katharinenhospital, Institute for Hospital Hygiene, Kriegsbergstr. 60, 70174 Stuttgart, Germany.

Clinical and Diagnostic Laboratory Immunology, May 2004, p. 569-576, Vol. 11, No. 3
1071-412X/04/$08.00+0     DOI: 10.1128/CDLI.11.3.569-576.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.





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