The mode of spread of Helicobacter pylori infection is
subject to ongoing debate. Recent
studies among patients with gastrointestinal disorders suggest a potential
role of conjugal
transmission. In this study, the clustering of H. pylori infection
was assessed among 110
employees of a health insurance company and their partners. Active infection
with H. pylori
was measured by the 13C-urea breath test. Information on potential
confounders was collected
by a standardized questionnaire. Overall, 16 employees (14·5%) and
24 partners (21·8%) were
infected. While only 7% (6/86) of employees with an uninfected partner
were infected, this
applied to 42% (10/24) of employees with an infected partner. A very
strong relation between
partners' infection status persisted after control for age and other
potential confounders
(adjusted odds ratio, 7·0; 95% confidence interval, 1·8–26·7).
Furthermore, the risk of infection
increased with the number of years lived with an infected partner. These
results support the
hypothesis of a major role of spouse-to-spouse transmission of H. pylori
infection.