[¹³C]-Urea breath test without prior fasting and without test meal is accurate for the detection of Helicobacter pylori infection in Chinese

Abstract Background and Aim: Conventional [¹³C]-urea breath test ([¹³C]-UBT) requires prior fasting and a test meal, which theoretically improves the accuracy of the test. However, recent studies have suggested that prior fasting and test meal may not be essential. We aimed to determine the accuracy of a new [¹³C]-UBT protocol without fasting in Chinese.

Methods: Dyspeptic patients referred for upper endoscopy were recruited. The gold standard for Helicobacter pylori infection was the combination of Campylobacter-like organism (CLO) test and histology. Group I (n = 213) patients underwent [¹³C]-UBT with prior fasting and with citrate acid test meal. Group II (n = 123) patients underwent [¹³C]-UBT without prior fasting but with test meal. Group III (n = 90) patients underwent [¹³C]-UBT without prior fasting and without test meal.

Results: The highest accuracy for groups I, II and III was 96.7, 95.1 and 95.5% using a cut-off value of 5.0, 5.5 and 3.5, respectively. The sensitivities and specificities were 97.4 and 95.8% in group I, 93.3 and 96.8% in group II, and 96.5 and 93.9% in group III, respectively.

Conclusion: The [¹³C]-UBT protocols without prior fasting and either with or without test meal produce highly accurate and reliable results in the Chinese population.