Which test is known for its highest sensitivity in detecting H. pylori?

The serology test detects antibodies against Helicobacter pylori and is often used in clinical settings. However, it is less preferred compared to other tests when it comes to sensitivity for current infection. The stool antigen test is known for having a high sensitivity and specificity for detecting active H. pylori infections. It measures the presence of H. pylori antigens in the stool and is particularly effective in diagnosing current infections, making it a strong choice.

The breath test, which detects urease activity from H. pylori, is also highly sensitive. Patients ingest a urea solution labeled with a carbon isotope, and if H. pylori is present, it metabolizes the urea, leading to the production of labeled carbon dioxide that can be measured in breath samples.

Endoscopic biopsy, while providing a definitive diagnosis through histological examination, is more invasive and is not primarily used for routine screening. Its sensitivity can be affected by the sampling technique and the location of the biopsy.

In summary, although the serology test is informative, it does not have the highest sensitivity for detecting active H. pylori infections when matched against stool antigen tests and breath tests. The stool antigen test is often preferred for its balance of sensitivity and non-invasive nature.