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E Crewe

Publications and source records attributed to E Crewe.

5 recordsLinked to original sources
PubMed2000

Which patients with hepatitis C develop liver complications?

To identify variables that are independent predictors of adverse outcomes in chronic hepatitis C, we analyzed a cohort of 455 patients followed for a median of 4.7 years. Associations were sought between demographic and behavioral factors, hepatitis C virus (HCV) genotype, liver histology and liver tests at entry, and development of liver complications, hepatocellular carcinoma (HCC), hepatic transplantation and liver-related death. Independent predictors were identified by multivariate analysis. The following were associated with a significantly higher rate of liver complications: age; birth in Asia, Europe, Mediterranean region, or Egypt; transmission by blood transfusion or sporadic cases; HCV genotypes 1b and 4 (compared with 1/1a); fibrosis stage 3 or 4 (cirrhosis); serum albumin; bilirubin; prothrombin time; and alpha-fetoprotein. However, the only independent predictors of liver-related complications were sporadic transmission (P <.001), advanced fibrosis (P =.004), and low albumin (P <.001). The corresponding independent risk factors for HCC were male gender (P =. 07), sporadic transmission (P <.001), and albumin (P <.001); bilirubin (P =.02) was an additional predictor of transplantation or liver-related death. It is concluded that only patients with advanced hepatic fibrosis or cirrhosis, are at risk of developing hepatic complications of chronic hepatitis C during 5-year follow-up. Among such patients, abnormalities in serum albumin, bilirubin, or prothrombin time indicate a high probability of complications. Patients without definite risk factors for HCV (sporadic cases) are at higher risk of complications, possibly because of interaction between older age, duration of infection, country of birth, and HCV genotypes 1b and 4.

Adult↗
PubMed1998

Effects of hepatitis G virus coinfection on severity of hepatitis C: relationship to risk factors and response to interferon treatment.

The aims of the present study were to identify characteristics that are more often associated with hepatitis G virus (HGV) coinfection in Australian patients infected with the hepatitis C virus (HCV) and to investigate the effects of HGV on the histological and functional severity of chronic hepatitis C. Serum samples from 209 patients with chronic hepatitis C were tested for HGV-RNA using single-round reverse transcriptase-polymerase chain reaction to primers directed at the NS5 region of the HGV genome. Hepatitis G virus RNA was detected in 40 cases (19%). Hepatitis G virus-coinfected patients tended to be younger and parenteral risks could be identified in all but six. Although country of birth did not differ significantly between the coinfected and HCV-alone groups, HGV-positive patients appeared to be less likely to have originated from Asia. On logistic regression analysis, HCV genotype 3a was found in a significantly higher proportion of patients with HGV coinfection than other genotypes (P < 0.01). Liver histology and response to interferon were similar in the HGV-coinfected and HCV-alone groups and liver-related complications appeared to occur less frequently in patients with both HGV and HCV. On univariate analysis, antipyrine clearance was found to be higher in the coinfected group (P < 0.05), implying better preservation of hepatic metabolic function, but this difference was lost when adjusted for HCV genotype. In conclusion, coinfection with HGV was more commonly associated with HCV genotype 3a, a genotype associated with injection drug use in younger patients. However, the presence of HGV coinfection did not adversely affect liver disease or the response to interferon treatment in patients with chronic hepatitis C.

Adult↗
PubMed1991

Hepatitis C virus infection in haemodialysis patients.

Antibody to hepatitis C has been variously detected in 1-20% of haemodialysis patients in recent studies from overseas. To determine the frequency of antibodies to the C100-3 protein of the hepatitis C virus (anti-HCV) a cross-sectional study was performed in 60 patients on maintenance haemodialysis in Western Sydney. Six patients (10%) were anti-HCV seropositive. Four of the six anti-HCV positive patients were also hepatitis B core antibody positive, compared with nine of 54 anti-HCV negative patients (p less than 0.05). All anti-HCV positive patients had received multiple blood transfusions. Serum alanine aminotransferase (ALT) was not useful as a screening test. Recent evidence suggests that anti-HCV seropositivity underestimates infectivity.

Antigens, Viral↗
PubMed1980

Further studies on neonatal rotavirus infections.

Forty newborn babies who were shown to be excreting rotaviruses within a few days of birth were tested daily for one month. Most were found to excrete virus for only a short period of time. In 48% of babies, virus was found on one day only, in 25% it was present for two days, and in 10% for three days. Most of these infections did not appear to confer lasting immunity. Only 21% of young children who excreted virus as neonates had detectable circulating complement-fixing antibodies when eight to eighteen months old. A survey of newborn babies showed that 89% of babies possessed the antibody, but, by the age of four to six months, the antibody was present only in 7%. This supports the view that infected neonates fail to develop circulating complement-fixing antibodies. Infection rates did not differ significantly between breast-fed and bottle-fed babies. Likewise, maternal antibody levels could not be shown to have any effect on infection. No rotavirus particles were found in breast milk.

Antibodies, Viral↗