Early diagnosis is important in controlling Helicobacter pylori-induced gastritis and progression to gastric malignancy. Serological testing is an efficient non-invasive diagnostic method, but currently does not allow differentiation between active and past infections. To fill this diagnostic gap we investigated the diagnostic value of a panel of 10 H. pylori specific antibodies in individuals with different H. pylori infection status within a German population.We used the recomLine Helicobacter IgG 2.0 immunoblotting assay to analyse 10 H. pylori specific antibodies in serum samples collected from 1108 volunteers. From these, 788 samples were used to build exposure and infection status models and 320 samples for model validation. H. pylori infection status was verified by histological examination. We applied logistic regression to select antibodies correlated to infection status and developed, with independent validation, discriminating models and risk scores. Receiving operating characteristic (ROC) analysis was performed to assess the accuracy of the discriminating models.Antibody reactivity against CagA, GroEL, and FliD was independently associated with the risk of H. pylori exposure with odds ratios (ORs) and 95% confidence intervals (95% CIs) of 99.24 (46.50-211.80), 46.17 (17.45-122.17) and 22.16 (8.46-55.04), respectively. A risk score comprising these 3 selected antibodies differentiated currently H. pylori infected or eradicated participants from negatives with an area under the curve (AUC) of 0.976 (95%CI: 0.965-0.987) (Model 1). Seropositivity for VacA, GroEL, FliD, HpaA, and gGT was associated with a current infection with an AUC of 0.870 (95%CI: 0.837-0.903), which may help discriminate currently infected patients from eradicated ones (Model 2).The recomLine assay is sensitive and specific in determining H. pylori infection and eradication status and thus represents a valuable tool in the management of H. pylori infection.Copyright © 2023. Published by Elsevier Ltd.