{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T04:46:58Z","timestamp":1782794818424,"version":"3.54.5"},"reference-count":144,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:00:00Z","timestamp":1778889600000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>Helicobacter pylori<\/jats:italic>\n                      <\/jats:styled-content>\n                      infection remains a major public health concern in Iran, where high prevalence, alarming antibiotic resistance, and significant gastric cancer burden necessitate a unified and evidence\u2010based national strategy. Despite the availability of international guidelines, gaps in clinical practice persist due to local epidemiology, resistance patterns, and diagnostic challenges. This study presents the first national Iranian consensus guideline for the diagnosis and management of\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>H. pylori<\/jats:italic>\n                      <\/jats:styled-content>\n                      infection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multidisciplinary panel of experts from leading Iranian gastroenterology centers convened between August 2023 and October 2025. Using the GRADE framework, the scientific committee conducted systematic literature reviews and formulated evidence\u2010based statements across diagnostic, therapeutic, and clinical management domains. Consensus was defined as \u2265\u200980% agreement. Twelve structured meetings, including a final hybrid national consensus conference, were held to refine recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The guideline delivers 35 evidence\u2010graded statements addressing indications for testing and treatment, optimal diagnostic modalities, and treatment pathways. Key recommendations include a strong preference for non\u2010invasive testing in patients under 45 without alarm features, endoscopic evaluation with targeted biopsies in high\u2010risk groups, and confirmation of eradication using urea breath test (UBT) or monoclonal stool antigen test (SAT) at \u2265\u20094\u2009weeks post\u2010treatment. Given Iran's high clarithromycin resistance (&gt;\u200920%), a course of 10\u201314\u2009days bismuth quadruple therapy (BQT) is recommended as first\u2010line treatment, with non\u2010bismuth concomitant therapy as an alternative. Susceptibility\u2010guided therapy is encouraged when feasible, particularly after treatment failure. High\u2010dose proton pump inhibitor (PPI) or potassium competitive acid blocker (P\u2010CAB)\u2010based acid suppression is emphasized to enhance eradication efficacy. Special considerations are provided for renal\/hepatic impairment and drug interactions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This national guideline provides a standardized, evidence\u2010based framework for improving\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>H. pylori<\/jats:italic>\n                      <\/jats:styled-content>\n                      diagnosis and management. By integrating local antimicrobial resistance patterns and practical clinical considerations, the guideline helps optimize eradication rates, reinforce antibiotic stewardship, and contribute to gastric cancer prevention efforts across Iran.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hel.70137","type":"journal-article","created":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T08:51:48Z","timestamp":1778921508000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["First Report of National Consensus Guidelines for the Diagnosis and Treatment of\n                    <i>Helicobacter pylori<\/i>\n                    Infection in Iran"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6772-0972","authenticated-orcid":false,"given":"Aryan","family":"Salahi\u2010Niri","sequence":"first","affiliation":[{"name":"Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9564-4631","authenticated-orcid":false,"given":"Anahita","family":"Sadeghi","sequence":"additional","affiliation":[{"name":"Digestive Disease Research Institute Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjan","family":"Mokhtare","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine Iran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5248-6546","authenticated-orcid":false,"given":"Foroogh","family":"Alborzi Avanaki","sequence":"additional","affiliation":[{"name":"Imam Khomeini Hospital GI Ward Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Taher","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Imam Khomeini Hospital Complex Tehran University of Medical Sciences  Tehran Iran"},{"name":"Liver Transplantation Research Center Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afsaneh","family":"Mirshahvelayati","sequence":"additional","affiliation":[{"name":"Dr. Abidi Pharmaceuticals Company  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Reza","family":"Zali","sequence":"additional","affiliation":[{"name":"Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9580-2676","authenticated-orcid":false,"given":"Amir","family":"Sadeghi","sequence":"additional","affiliation":[{"name":"Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2135-7581","authenticated-orcid":false,"given":"Abbas","family":"Yadegar","sequence":"additional","affiliation":[{"name":"Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,16]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/CEG.S256627"},{"issue":"1","key":"e_1_2_15_3_1","first-page":"S52","article-title":"Mortality Trends of Gastrointestinal Cancers in Iranian Population","volume":"6","author":"Pourhoseingholi M. 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