{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T07:46:49Z","timestamp":1781250409818,"version":"3.54.1"},"reference-count":6,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>We appreciate the constructive comments provided by Dr. Parena Maheshwari regarding our article, \u201cAsia\u2010Pacific Survey on the Management of <jats:styled-content style=\"fixed-case\"><jats:italic>Helicobacter pylori<\/jats:italic><\/jats:styled-content> Infection.\u201d The objective of this study was to investigate the extent of overall agreement among clinicians in the Asia\u2010Pacific region regarding the management of <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content> infection. Our findings highlight key challenges, including limited access to potassium\u2010competitive acid blockers, low implementation of antibiotic susceptibility tests, and continued reliance on empirical regimens. Although vonoprazan is widely used in Japan, its adoption elsewhere remains limited due to regulatory and economic barriers. Notably, only 14.3% of clinicians reported using susceptibility\u2010guided therapy, hindered by the decline in culture\u2010based methods, cost issues, and limited laboratory infrastructure. We emphasize the urgent need for expanded access to molecular diagnostic tools and cost\u2010effectiveness studies to inform future strategies. Subgroup analyses revealed regional variability; however, further studies are warranted to further examine specialty\u2010based and intra\u2010regional differences. Eradication therapy in pediatric and elderly populations also poses unique challenges. Concerns regarding long\u2010term safety limit standardized protocols in children, while in elderly patients, evidence for gastric cancer prevention, particularly in those aged \u2265\u200980\u2009years, remains insufficient. We are encouraged by the interest our work has generated and believe that this exchange highlights critical areas for future research, including antimicrobial resistance surveillance, individualized treatment approaches, and strengthening of health system capacities. We hope this dialogue will facilitate further research and contribute to improved <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content> management across the Asia\u2010Pacific region.<\/jats:p>","DOI":"10.1111\/jgh.70087","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T11:15:31Z","timestamp":1758798931000},"page":"2648-2650","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Response to the Letter by Dr. Parena Maheshwari Regarding Our Manuscript, \u201cAsia\u2010Pacific Survey on the Management of <scp><i>Helicobacter pylori<\/i><\/scp> Infection\u201d"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9075-6415","authenticated-orcid":false,"given":"Koji","family":"Otani","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Medicine Osaka Metropolitan University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dao\u00a0Viet","family":"Hang","sequence":"additional","affiliation":[{"name":"Internal Medicine Faculty Hanoi Medical University  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6407-5245","authenticated-orcid":false,"given":"Rapat","family":"Pittayanon","sequence":"additional","affiliation":[{"name":"Internal Medicine King Chulalongkorn Memorial Hospital and Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medicine Queen Elizabeth Hospital  King's Park Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9811-7546","authenticated-orcid":false,"given":"Kee\u00a0Huat","family":"Chuah","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Unit, Department of Medicine University of Malaya  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Hsiang","sequence":"additional","affiliation":[{"name":"Mount Elizabeth Medical Centre Richmond Gastroenterology Centre  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9950-9899","authenticated-orcid":false,"given":"Akira","family":"Higashimori","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Medicine Osaka Metropolitan University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Medicine Osaka Metropolitan University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The Upper GI Focus Group of the APAGE\u2010ELC","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,25]]},"reference":[{"key":"e_1_2_1_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.13143"},{"key":"e_1_2_1_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1590-8658(03)00081-1"},{"key":"e_1_2_1_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000001594"},{"key":"e_1_2_1_9_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000022000"},{"key":"e_1_2_1_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01843-8"},{"key":"e_1_2_1_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.13125"}],"container-title":["Journal of Gastroenterology and 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