. "Appendix D-5: The Prospects for Immunizing Against Hepatitis B Virus." New Vaccine Development: Establishing Priorities: Volume II, Diseases of Importance in Developing Countries. Washington, DC: The National Academies Press, 1986.
aAssuming a case fatality rate of 1.5 per 1,000 cases.
bIncidence rate in China assumed applicable to all high-risk regions.
cAssumed to be close to Israel’s rate of 50 to 80 per 100,000.
dAssumed to be between rates in Israel and the United States.
SOURCE: Francis, personal communication, 1985.
Cases and deaths were divided proportionally by population size into the 5 to 14 and 15 to 59 years age groups. It was assumed that all cases in the under 5 years age group are asymptomatic, and that the number of cases in people 60 years of age and over is insignificant.
Cases were distributed into the acute categories as follows: 5 to 14 years age group, 25 percent in category A, 50 percent in category B, and 25 percent in category C; 15 to 59 years age group, 25 percent in category A, 25 percent in category B, and 50 percent in category C. An additional 3 percent of cases in each age group were assigned to category E, representing cases of chronic acute hepatitis (Berlin, 1980). Table D-5.2 shows the disease burden resulting from acute hepatitis B.
Primary Hepatocellular Carcinoma
PHC may occur in chronic hepatitis B carriers 20 years or more after an acute infection. The average survival rate of PHC is 6 months, so the numbers of cases and deaths are equal. The incidence rates in different populations are shown in Table D-5.3. Because of the time lag between acute hepatitis infection and PHC onset, it was assumed that the disease affects only two age groups. Cases and deaths were distributed proportionally according to the size of the population in each age group, and all cases were assigned to category E. Table D-5.4 shows the disease burden estimates for PHC.