Advantages and disadvantages of diagnostic testing for Helicobacter pylori

 

Advantages and disadvantages of diagnostic testing for Helicobacter pylori

Test Methods	Advantage	Disadvantage
Histology	Excellent Sensitivity and specificity	Expensive and requires infrastructure and trained personnel
Rapid Urease Testing	Inexpensive and provides rapid results. Excellent specificity and very good sensitivity in properly selected patients.	Sensitivity significantly reduced in post- treatment setting
Culture	Excellent specificity. Allows determination of antibiotic sensitivities.	Expensive, difficult to perform, and not widely available.
Antibody testing(quantitative and qualitative)	Inexpensive, widely available, very good negative predictive value (NPV).	Positive predictive value (PPV) dependent upon backgroundH. pylori prevalence. Not recommended after H.pyloritherapy.
Urea breath tests	Identifies active H.pylori infection. Excellent PPV and NPV regardless of H.pylori prevalence.
Fecal antigen test	Identifies active H.pylori infection. Excellent positive and negative predictive values regardless of H.pylori prevalence. Useful before and after H.pylori therapy.	Polyclonal test less well validated than the UBT in the post-treatment setting. Monoclonal test appears reliable before and after antibiotic therapy. Unpleasantness associated with collecting stool.