Objective:To identify serum biomarkers that may predict the short or long term outcomes of anti-Helicobacter pylori(H.pylori)treatment,a follow-up study was performed based on an intervention trial in Linqu County,China.Methods:A total of 529 subjects were selected randomly from 1,803 participants to evaluate total anti-H.pylori immunoglobulin G(Ig G)and 10 specific antibody levels before and after treatment at 1-,2-and 7.3-year.The outcomes of anti-H.pylori treatment were also parallelly assessed by 13C-urea breath test at 45-d after treatment and 7.3-year at the end of follow-up.Results:We found the medians of anti-H.pylori Ig G titers were consistently below cut-off value through 7.3years in eradicated group,however,the medians declined in recurrence group to 1.2 at 1-year after treatment and slightly increased to 2.0 at 7.3-year.While the medians were significantly higher(>3.0 at 2-and 7.3-year)among subjects who failed the eradication or received placebo.For specific antibody responses,baseline seropositivities of Fli D and Hpa A were reversely associated with eradication failure[for Fli D,odds ratio(OR)=0.44,95%confidence interval(95%CI):0.27–0.73;for Hpa A,OR=0.32,95%CI:0.17–0.60].The subjects with multiple positive specific antibodies at baseline were more likely to be successfully eradicated in a linear fashion(Ptrend=0.006).Conclusions:Our study suggested that total anti-H.pylori Ig G level may serve as a potential monitor of longterm impact on anti-H.pylori treatment,and priority for H.pylori treatment may be endowed to the subjects with multiple seropositive antibodies at baseline,especially for Fli D and Hap A. Objective: To identify serum biomarkers that may predict the short or long term outcomes of anti-Helicobacter pylori (H. pylori) treatment, a follow-up study was performed based on an intervention trial in Linqu County, China. Methods: A total of 529 subjects were selected randomly from 1,803 participants to evaluate total anti-H. pylori immunoglobulin G (Ig G) and 10 specific antibody levels before and after treatment at 1-, 2-and 7.3-year. These outcomes of anti-H. pylori treatment were also parallelly assessed by 13 C-urea breath test at 45-d after treatment and 7.3-year at the end of follow-up. Results: We found the medians of anti-H.pylori Ig G titers were consistently below cut-off value through 7.3years in eradicated group, however, the medians declined in recurrence group to 1.2 at 1-year after treatment and slightly increased to 2.0 at 7.3-year .While the medians declined significantly (> 3.0 at 2-and 7.3-year ) among subjects who failed the eradication or received placebo. For specific antibody resp onses, baseline seropositivities of Fli D and Hpa A were reversely associated with eradication failure [for Fli D, odds ratio (OR) = 0.44, 95% confidence interval (95% CI): 0.27-0.73; for Hpa A, OR = 0.32 , 95% CI: 0.17-0.60] .The subjects with multiple positive specific antibodies at baseline were more likely to be successfully eradicated in a linear fashion (Ptrend = 0.006) .Conclusions: Our study suggested that total anti-H.pylori Ig G level may serve as a potential monitor of longterm impact on anti-H. pylori treatment, and priority for H. pylori treatment may be endowed to the subjects with multiple seropositive antibodies at baseline, especially for Fli D and Hap A.