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Vaccines for the 21st Century: A Tool for Decisionmaking (2000)
Institute of Medicine (IOM)

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. "Appendix 7: Helicobacter pylori." Vaccines for the 21st Century: A Tool for Decisionmaking. Washington, DC: The National Academies Press, 2000.

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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

Page
183
Front Matter (R1-R12)
Executive Summary (1-10)
Introduction (11-16)
Progress in Vaccine Development (17-38)
Considerations of Candidate Vaccines (39-52)
Overview of Analytic Approach and Results (53-92)
Review of the Analytical Model (93-108)
Ethical Considerations and Caveats (109-122)
Observations (123-132)
References (133-142)
Appendix 1: Borrelia burgdorferi (143-148)
Appendix 2: Chlamydia (149-158)
Appendix 3: Coccidioides Immitis (159-164)
Appendix 4: Cytomegalovirus (165-172)
Appendix 5: Enterotoxigenic E. coli (173-176)
Appendix 6: Epstein-Barr Virus (177-180)
Appendix 7: Helicobacter pylori (181-188)
Appendix 8: Hepatitis C (189-194)
Appendix 9: Herpes Simplex Virus (195-206)
Appendix 10: Histoplasma capsulatum (207-212)
Appendix 11: Human Paillomavirus (213-222)
Appendix 12: Influenza A and B (223-232)
Appendix 13: Insulin-Dependent Diabetes Mellitus (233-238)
Appendix 14: Melanoma (239-244)
Appendix 15: Multiple Sclerosis (245-250)
Appendix 16: Mycobacterium tuberculosis (251-256)
Appendix 17: Neisseria gonnorrhea (257-266)
Appendix 18: Neisseria meningitidis (267-272)
Appendix 19: Parainfluenza Virus (273-278)
Appendix 20: Respiratory Syncytial Virus (279-284)
Appendix 21: Rheumatoid Arthritis (285-290)
Appendix 22: Rotavirus (291-294)
Appendix 23: Shigella (295-298)
Appendix 24: Streptococcus, Group A (299-304)
Appendix 25: Streptococcus, Group B (305-312)
Appendix 26: Streptococcus pneumoniae (313-322)
Appendix 27: Information on accessing Electronic Spreadsheets (323-324)
Appendix 28: Summary of Workshops (325-434)
Appendix 29: Questions Posed to Outside Experts and List of Responders (435-442)
Index (443-460)