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Vaccines for the 21st Century: A Tool for Decisionmaking
Table A7–2 Disease Scenarios for H. pylori Infection
No. of Cases
% of Cases
Committee HUI Values
Duration (years)
GASTRITIS:
Gastritis
371,675
30.0%
acute gastritis at initial infection
0.74
0.0192 (1 week)
Gastritis—recurrent
185,838
15.0%
chronic mild symptoms—no transition to PUD
0.74
1.5848 (2 days/month for life)
Gastritis to Peptic Ulcer Disease
123,892
10.0%
chronic mild symptoms until PUD diagnosis made
0.74
2 days/month; continues for average of 30 years
PEPTIC ULCER DISEASE
Peptic Ulcer Disease
123,892
10.0%
acute PUD
0.61
0.0192 (1 week)
Peptic Ulcer Disease (untreated or recurrence)
61,946
5.0%
0.74
1.0832 (2 days/month for life)
Peptic Ulcer Disease (w/complications)
2,478
0.2%
0.4
0.0384 (2 weeks)
GASTRIC CANCERS
Gastric Adenocarcinoma
12,389
1.0%
0.82
1.0000 (average life expectancy from diagnosis)
Lymphomas/MALTomas
6,195
0.5%
0.82
7.5000 (average life expectancy from diagnosis)
It was assumed that there is a 30-year latency between time of infection and acute peptic ulcer disease; half of the people with acute peptic ulcer disease experience chronic peptic ulcer disease for the duration of their lives.
It was further assumed that a small proportion (1.5%) of infected people develop cancer secondary to the H. pylori infection and that the cancers are diagnosed around age 70 and that these people die within a year. HUI states associated with these latent conditions range from .40 for acute complications of peptic ulcer disease to .74 for recurrences of chronic, mild peptic ulcer disease, to .82 for the average state during the year of life from diagnosis of cancers to death.
COST INCURRED BY DISEASE
Table A7–3 summarizes the health care costs incurred by H. pylori infections. For the purposes of the calculations in this report, it was assumed that