Clustering of Helicobacter pylori Infection in Couples: Differences Between High- and Low-Prevalence Population Groups

Purpose Several mostly small-scale studies reported clustering of Helicobacter pylori infections as a possible indicator of conjugal transmission, but results have been inconsistent. We assessed clustering of H pylori infections in a large community-based study from Germany that included both high-prevalence and low-prevalence population subgroups. Methods Current H pylori infection was determined among 670 couples by means of carbon-13-urea breath test (13C-UBT) breath test and a monoclonal antigen immunoassay for H pylori in stool. Results Prevalences of infection among women were 34.9% (51 of 146 women) if the partner was infected and 14.5% (76 of 524 women) if the partner was not infected. Stratification by nationality showed a strong association of infection for partners with other than German nationality (adjusted odds ratio [OR], 6.05; 95% confidence interval [CI], 1.31–17.96), for whom prevalence of infection was greater than 50%, whereas no association was seen for German partners born in Germany (OR, 1.10; 95% CI, 0.47–2.61), for whom infection prevalence was approximately 10% (p for interaction = 0.048). Conclusions Conjugal transmission of infection caused by H pylori is unlikely to be of relevance in low-prevalence population groups. Our results are consistent with the hypothesis of a potential role of conjugal transmission of H pylori infection in high-prevalence population groups.