Clinical Significance of Helicobacter pylori Seropositivity and Seronegativity in Asymptomatic Blood Donors

To determine the clinical significance ofHelicobacter pylori seropositivity and seronegativity inhealthy blood donors, we carried out a serologicalevaluation of Helicobacter pylori status and endoscopy in a healthy blood donors population. In all,1010 donors were screened for Helicobacter pylori by IgGELISA and assessed for pepsinogen I and gastrin levelsby RIA; 298 IgG seropositive and 61 seronegative subjects underwent endoscopy with biopsies. Of359, 165 were also tested for CagA by western blotting.Of the 298 IgG seropositives, 274 were shown to beinfected on biopsy testing. Endoscopy revealed 70 peptic ulcers, 41 cases of erosive duodenitis,and two gastric cancers. In all 105 seropositive donorswere tested for CagA and 69 were CagA positive [34/58gastritis (58.6%), 24/35 duodenal ulcer (68.6%) and 11/12 gastric ulcer (91.6%)].Histologically active/chronic gastritis was associatedwith CagA: 88.4% vs 50% (CagA seropositive vsseronegative). Of the 61 IgG seronegatives, 59 werenegative on biopsy testing. At endoscopy three had duodenitis. Ofthe 60/61 IgG seronegatives tested for CagA, one had amoderate reaction. Duodenal ulcer donors showed higherpepsinogen I levels than donors without duodenal ulcers (97.7 μg/ml vs 80.9 μg/mlrespectively). Screening for Helicobacter pylori andanti-CagA seropositivity and pepsinogen I can identifyindividuals likely to have gastroduodenal pathology evenin the absence of symptoms.