000131556 001__ 131556 000131556 005__ 20240212142201.0 000131556 0247_ $$2doi$$a10.15403/jgld-3161 000131556 0248_ $$2sideral$$a127248 000131556 037__ $$aART-2021-127248 000131556 041__ $$aeng 000131556 100__ $$0(orcid)0000-0001-6522-6682$$aAlcedo J.$$uUniversidad de Zaragoza 000131556 245__ $$aThe validity of the invasive tests for helicobacter pylori diagnosis is unequally affected by the consumption of antibiotics or pump inhibitors. test performance under real-world conditions 000131556 260__ $$c2021 000131556 5203_ $$aBackground & Aims: Patients undergoing upper endoscopy have often used proton pump inhibitors (PPI) and/or antibiotics (ABx) recently. Both drugs have been associated with a poorer yield of the Helicobacter pylori (H. pylori) diagnostic tests. The aim was to assess the accuracy of the polymerase chain reaction test (qPCR), histological exam (HE) and ultra-fast urease test (UFUT) for H. pylori detection in patients that recently used PPI or ABx. Methods: Prospective study recruiting 206 patients who underwent upper endoscopy and gastric biopsies. Demographics and use of PPI/ABx were obtained. Sensibility (Sn), specificity (Sp), predictive value (PV), likelihood ratio (LR) and PABAK concordance index, were calculated, considering as the gold standard the positivity of 2 out of 3 analyzed tests. A global analysis and another one based on the PPI/ABx intake were performed. Results: 48.5% of patients used PPI and 12.8% ABx within the 2 and 4 weeks prior to endoscopy, respectively. The UFUT was positive in 13.1% of patients, HE in 34% and qPCR in 35.9%. UFUT achieved lower Sn (37%) than HE (98%) and qPCR (98%) (p<0.001) overall. ABx were associated with lower Sn in HE (p=0.04) and lower Sp in qPCR (p=0.03). PPI did not associate with a significant drop in Sn and Sp. The concordance between HE and qPCR was 0.83 (95%CI: 0.73-0.89). Conclusions: Under real world conditions, the accuracy and concordance of HE and qPCR to diagnose H. pylori were excellent, but UFUT achieved unsatisfactory outcomes. The intake of ABx was associated with the worse performance, fundamentally for HE. The PPI did not reduce the tests‘ yield significantly. © 2021, Romanian Society of Gastroenterology. All rights reserved. 000131556 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/ 000131556 590__ $$a2.142$$b2021 000131556 591__ $$aGASTROENTEROLOGY & HEPATOLOGY$$b85 / 92 = 0.924$$c2021$$dQ4$$eT3 000131556 592__ $$a0.496$$b2021 000131556 593__ $$aMedicine (miscellaneous)$$c2021$$dQ3 000131556 593__ $$aGastroenterology$$c2021$$dQ3 000131556 594__ $$a3.5$$b2021 000131556 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000131556 700__ $$0(orcid)0000-0001-6883-8940$$aCasas D. 000131556 700__ $$0(orcid)0000-0001-9054-3030$$aGotor J. 000131556 700__ $$0(orcid)0000-0001-8471-3224$$aLafuente M.$$uUniversidad de Zaragoza 000131556 700__ $$aLlorente M. 000131556 700__ $$aSanz-Segura P.$$uUniversidad de Zaragoza 000131556 700__ $$aMonzón R. 000131556 700__ $$aHörndler C. 000131556 700__ $$aPeña-Galo E. 000131556 7102_ $$12007$$2265$$aUniversidad de Zaragoza$$bDpto. Métodos Estadísticos$$cÁrea Estadís. Investig. Opera. 000131556 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina 000131556 773__ $$g30, 2 (2021), 198-204$$pJournal of Gastrointestinal and Liver Diseases$$tJournal of Gastrointestinal and Liver Diseases$$x1841-8724 000131556 8564_ $$s310494$$uhttps://zaguan.unizar.es/record/131556/files/texto_completo.pdf$$yVersión publicada 000131556 8564_ $$s2549360$$uhttps://zaguan.unizar.es/record/131556/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000131556 909CO $$ooai:zaguan.unizar.es:131556$$particulos$$pdriver 000131556 951__ $$a2024-02-12-13:56:00 000131556 980__ $$aARTICLE