Hu Y, et al. - This meta-analysis strived to assess the global recurrence rate following Helicobacter pylori (H. pylori) eradication therapy and confirm its relationship with socioeconomic and sanitary conditions. This systematic review concluded that H. pylori recurrence remained a problem closely correlated with socioeconomic and sanitary conditions. In developing countries, methods to reduce recurrence were needed.

• The researchers performed a systematic search of PubMed, EMBASE and the Cochrane library to identify potentially relevant publications using the following keywords: “Helicobacter pylori” or “H. pylori” or “Hp” and “recurrence” or “recrudescence” or “reinfection” or “recurrent” or “recurred” or “re-infect*” or “relapse*.”

• The researchers examined 132 studies (53 934 patient-years).
• They weighted each study according to the duration of patient-years.
• 4.3% (95% CI, 4-5), 3.1% (95% CI, 2-5) and 2.2% (95% CI, 1-3) were the global annual recurrence, reinfection and recrudescence rate of H. pylori, respectively.
• The H. pylori recurrence rate was inversely associated with the human development index (HDI) (ie, 3.1% [95% CI, 2-4], 6.2% [95% CI, 4-8] and 10.9% [95% CI, 6-18] in countries with a very high, high and medium or low HDI) (P <.01) and directly associated with H. pylori prevalence (10.9% [95% CI, 7-16], 3.7% [95% CI, 3-5], 3.4% [95% CI, 2-5] and 1.6% [95% CI, 0.5-3] in countries with a very high, high, medium or low local H. pylori prevalence) (P <.01).
• Between the 1990s, 2000s, and 2010s, global recurrence rates remained relatively stable but varied across different regions (P <.05).