Commentary: H. pylori infection in early life and the problem of imperfect tests

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Abstract
Helicobacter pylori infection is associated with significant disease outcomes, including peptic ulcers and gastric cancers. While persistent infection appears to be established during childhood, little is known about infection patterns in early life. Goodman et al.1 report a first time infection rate of 27% among 468 children of the Pasitos cohort followed at 6-month intervals from birth to 24 months using the 13C urea breath test. They also report that 77% of the children lost infection during follow-up and 19% of those who did so were reinfected at a later time. Since infection in childhood may well determine the outcome of disease over a lifetime, this well-designed study—including a bi-national structure and systematic testing targets—can add immensely to our knowledge of early childhood infection as well as to our experience with non-invasive testing in infants and toddlers.

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