Helicobacter pylori serology
H. pylori serology is not considered clinically useful and is not offered by BJH as well as most reference laboratories.
- Helicobacter pylori is a common chronic bacterial infection that is associated with chronic gastritis, peptic ulcer disease, gastric adenocarcinoma and gastric mucosa-associated lymphoid tissue lymphoma (MALT).
- Testing for H. pylori should be performed only if the clinician plans to offer treatment for positive results.
- Diagnostic strategies for H. pylori include the following:
- Noninvasive approaches: urea breath test, stool antigen test, serology
- Invasive: endoscopy-based testing with rapid urease test (CLO test), culture, immunohistochemistry of biopsy
- Established guidelines from the American College of Gastroenterologists (ACG) and the American Gastroenterology Association (AGA) recommend stool antigen or urea breath testing as preferred diagnostic modalities.
- H. pylori serology can remain positive long after eradication and is not recommended by ACG guidelines.
- A negative H. pylori serology result does not rule out infection.
- Positive H. pylori serology cannot distinguish active from past infection.
- Many major insurance providers will not reimburse for this testing.
- H. pylori serology is not considered clinically useful and is not offered by BJH as well as most reference laboratories.
- Alternative noninvasive diagnostic approaches are available in-house, including the H. pylori stool antigen test (LAB397) with a turnaround time of less than 24 hours or urea breath test (offered by the GI service for inpatients).
- Chey WD et al. Am J Gastroenterol. 2017;112(2):212-239.
- Theel ES et al. J Clin Microbiol 2015;53(4):1358-1360.
- Chey WD & Wong BC: American College of Gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol 2007;102:1808-1825.
Written by: Patricia Hernandez, MD
Reviewed by: Melanie Yarbrough, PhD
Last Edited: 2024-08-29
Last Reviewed: 2024-08-29