High H. pylori Prevalence Found in Underserved Asymptomatic Population: Study
According to a study published in Clinical Gastroenterology and Hepatology , nearly two-thirds (64%) of asymptomatic individuals receiving care at a safety net center, which typically serves underserved patients, were seropositive for Helicobacter pylori. This indicates a significantly high prevalence of the bacterium within this specific population, even in the absence of symptoms. The study was conducted by Aaron P. and colleagues.
This study aimed to identify the seroprevalence of Helicobacter pylori among a predominantly underresourced, immigrant, and minority population in the United States and differences in prevalence according to demographic and generational subgroups in the service of informing more equitable gastric cancer screening strategies.
In this cross-sectional, population-based study, asymptomatic individuals aged 30-65 years with no prior history of H. pylori testing or treatment were studied. All eligible participants completed a structured survey and underwent blood sampling for H. pylori IgG serology testing. Of these, 1021 were screened. The study population had a mean age of 47.5 years, with 69.9% females and 30.1% males. The majority of participants, 88.7%, were Hispanic. Overall seroprevalence rates were estimated, as well as in predefined subgroups including sex, ethnicity, place of birth, and immigrant generation status.
Results
Of the 1021 people screened, 63.9% were seropositive for H. pylori (95% CI: 60.9%–66.8%).
Seroprevalence did not change significantly with increasing age but was higher among men at 69.1% (95% CI, 63.9%–74.2%) than among women at 61.6% (95% CI, 58.1%–65.2%).
Ethnic disparities were also pronounced: the highest prevalence was in Hispanics at 65.9% (95% CI, 62.8%–69.0%), while the lowest prevalence was among non-Hispanic Whites at 45.0% (95% CI, 23.2%–66.8%).
The highest prevalence was found among participants born in Central America, at 75.1%.
There was no significant difference in the risk of infection between second- and third-generation immigrants, suggesting continued exposure risk extending beyond the first generation.
This population-based study demonstrated the high seroprevalence of Helicobacter pylori infection in nearly two-thirds of asymptomatic individuals within a high-risk, underserved population in the United States. The consistently high prevalence across all subgroups indicated that screening based on race and ethnicity alone might not catch critical drivers of risk and may inadvertently perpetuate existing disparities.
Reference:
Thrift, A. P., Dinarvand, P., Juarez, L., Brown, J., Avila, D., Zafiro Garcia-Villanueva, J. M., Danek, L. C., Mahmood, H., Porter, T., Gotschall, A., Pirzada, N. F., Rueda, J. J., Lu, L. B., Ali, A., Anyakorah, I., Bhattarai, S. J., Fatima, A., Garcia, J., Nguyen, H. V., … Tan, M. C. (2025). Seroprevalence of Helicobacter pylori infection among asymptomatic patients served by a safety-net healthcare system. Clinical Gastroenterology and Hepatology: The Official Clinical Practice Journal of the American Gastroenterological Association. https://doi.org/10.1016/j.cgh.2025.10.005
