Helicobacter pylori

Helicobacter pylori is a Gram-negative rod-shaped bacterium. It infects the mucous membrane of the stomach in more than half of the world’s population and is therefore one of the most common bacterial infectious agents of all. The infection is usually acquired in childhood and persists for decades if not actively treated.

Infection with H. pylori always causes an inflammatory reaction of the stomach mucosa, which can be detected in a fine tissue examination of the stomach. However, it does not necessarily cause any symptoms; more than 80 % of those infected remain asymptomatic. However, secondary diseases can develop on the basis of H. pylori gastritis. The most important secondary diseases are

• Stomach ulcer
• Duodenal ulcer
• Stomach cancer (adenocarcinoma)
• Lymphoma of the stomach (MALT lymphoma)

Diagnostic evidence of H. pylori infection is usually obtained during a gastroscopy, where samples (biopsies) are taken and examined for H. pylori. It is also possible to detect an
H. pylori infection by a breath test or a stool test.

A vaccination against H. pylori is currently not available.

Therapy is carried out with a combination of antibiotics and acid secretion inhibitors. The aim of the therapy is the complete elimination of the pathogens from the patient’s body (eradication). Since the risk of infection among adults in Germany is low, the risk of acquiring an H. pylori infection again after successful eradication therapy is also very low (less than 1% per year).

Helicobacter pylori and cancer

An existing infection with H. pylori increases the risk of stomach cancer by a factor of 4-6. H. pylori has been officially classified as a carcinogen since 1994, and this classification was confirmed in 2009.

As with many other carcinogens, H. pylori infection only leads to cancer in a small proportion of those infected, and there are usually decades between infection and the onset of cancer. This makes it difficult to prove the effect of a therapy on the incidence of cancer. However, there are now several studies from countries with high H. pylori infection rates and high gastric cancer incidence that show that in such countries, consistent treatment of H. pylori infections can reduce gastric cancer mortality. Therefore, in many countries, treatment of every H. pylori infection is now recommended for cancer prophylaxis. In Germany, the current DGVS guideline recommends offering patients eradication therapy even in cases of asymptomatic H. pylori infection.

The National Reference Center (NRC) for Retroviruses was newly appointed on October 1, 2016. Our range of services in the field of retrovirology includes, among others, comprehensive retrovirological diagnostics, medical consultation in difficult cases related to HIV or HTLV infections, frequent exchange with public health authorities and quality assurance in the field of retrovirus diagnostics at both national and international level.

The activities of the NRC for Retroviruses are supported by basic, translational and clinical research projects on HIV at the Max von Pettenkofer-Institute.

Biannually, we publish a Retrovirus Bulletin in German. In this bulletin, current scientific and clinical topics from the entire spectrum of retrovirology are presented for a broad medical and scientific audience as well as individuals living with HIV.

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