Increased prevalence of Helicobacter pylori and CagA seropositivity in Bulgarian children with type 1 diabetes mellitus.

INTRODUCTION: There is limited information on the prevalence of Helicobacter pylori seropositivity in pediatric patients with type 1 diabetes mellitus (T1DM), despite the fact that both conditions constitute significant healthcare issues. However, in these children, H. pylori seropositivity may worsen both glycemic control and diabetes management. MATERIALS AND METHODS: This study sought to determine the prevalence of CagA IgG and H. pylori IgG antibodies in Bulgarian children with T1DM. RESULTS: Of the 334 children assessed, 20.4% were H. pylori seropositive and 15.0% were CagA seropositive. Fewer children aged 1 to 6 years tested positive for H. pylori (12.2%) and CagA (8.7%) than those aged 7 to 17 years (24.7% and 18.3%, respectively). Among the 145 diabetic children, 28.3% were H. pylori positive versus only 14.3% of the 189 control participants. In addition, significantly more (23.4%) diabetic children were CagA positive, compared to 8.5% among the controls. CONCLUSION: H. pylori seropositivity was twice as common in children with T1DM compared to the control group. Likewise, pediatric patients were approximately three times more frequently seropositive for more virulent strains (CagA-positive status) than other children. If confirmed as an active infection, early diagnosis of H. pylori- and CagA-seropositive children may lower the lifetime risk of gastric cancer and peptic ulcers in adulthood. The current study's findings support additional prospective research before screening recommendations are issued.