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Omar H, Waked I, Elakel W, Salama R, Abdel-Razik W, Elmakhzangy H, Abdel-Rahman YO, Saeed R, Elshafaey A, Ziada DH, Ismail SA, Dabbous HM, Esmat G. Evolution of liver fibrosis after interferon-based anti-hepatitis C virus therapy failure in 3,049 chronic hepatitis C patients without cirrhosis. Arab J Gastroenterol 2023; 24:65-72. [PMID: 36725374 DOI: 10.1016/j.ajg.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/11/2022] [Accepted: 01/03/2023] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND STUDY AIMS Liver fibrosis is the underlying causeof hepatitis C virus (HCV)-related disease progression to endpoints such as cirrhosis, liver failure, and hepatocellular carcinoma. The aim of our study was to assess changes in hepatic fibrosis in patients with chronic HCV who had a fibrosis evaluation at two time points at least six months apart. PATIENTS AND METHODS This was a retrospective cohort study that included patients who had failed interferon therapy and received HCV retreatment with direct-acting antivirals (DAAs) at least six months later. Patients were evaluated previously for fibrosis according to liver biopsy and fibrosis biomarkers were evaluated before pegylated interferon and ribavirin (PEG/RBV) therapy. Fibrosis was re-evaluated with fibrosis-4 (FIB-4) scores before starting DAAs. RESULTS A total of 3,049 patients were included [age 43.47 ± 9.07 years, 55.20 % males] and baseline histopathology showed F1, F2, and F3 in 16.86 %, 46.21 %, and 36.93 %, respectively. The mean time interval between the last dose of previously failed IFN-therapy to the first dose of DAAs was 2.38 (±1.07) years. Overall, there was a significant increase in FIB-4 scores at retreatment times (from 11.71 ± 1.13 to 22.26 ± 1.68, p < 0.001). Patients with baseline FIB-4 < 1.45 (n = 1,569) and between 1.45 and 3.25 (n = 1,237) had significant increases in their FIB-4 at the retreatment time point [median difference; 0.41 (0.91) and 0.24 (1.5), p < 0.001, respectively], whereas patients with FIB-4 > 3.25 had significant reduction of their FIB-4 score at a retreatment timepoint [-0.98 (2.93), p ≤ 0.001]. CONCLUSION Fibrosis progressed in most patients, even within six months for some patients, and this indicates retreatment of non-system vascular resistance patients even if they do not have significant fibrosis.
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Affiliation(s)
- Heba Omar
- Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Egypt.
| | - Imam Waked
- Hepatology Department, National Liver Institute, Menoufiya University, Shebeen El Kom, Egypt
| | - Wafaa Elakel
- Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Egypt
| | - Rabab Salama
- Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Egypt
| | - Wael Abdel-Razik
- Hepatology Department, National Liver Institute, Menoufiya University, Shebeen El Kom, Egypt
| | - Hesham Elmakhzangy
- Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Egypt
| | | | | | - Arwa Elshafaey
- Public Health and Community Medicine, Cairo University, Cairo, Egypt
| | - Dina H Ziada
- Tropical Medicine and Infectious Disease, Tanta University, Egypt
| | | | - Hany M Dabbous
- Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Gamal Esmat
- Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Egypt
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Gamal Eldeen H, Hassany M, Elakel W, AbdAllah M, Abdel-Razek W, Elshazly Y, Dabbous HM, Hamdy El-Sayed M, El-Serafy M, Waked I, Esmat G, Doss W, Hashem A. Seroprevalence of HBV/HCV coinfection among patients with HCV screened during the national campaign for HCV eradication in Egypt. Arab J Gastroenterol 2022; 23:259-262. [PMID: 36336587 DOI: 10.1016/j.ajg.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 05/06/2022] [Accepted: 06/15/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND STUDY AIMS Little is known about the true prevalence of hepatitis B virus (HBV) coinfection in patients with hepatitis C virus (HCV). This multicenter nationwide study aimed to assess the seroprevalence of HBV among Egyptian patients with HCV and its possible risk factors. PATIENTS AND METHODS This is a cross-sectional, multicenter, nationwide study. Data were extracted from the National Network of Viral Hepatitis Treatment Centers database. Baseline data of patients proved to be viremic during the national campaign for HCV eradication (October 2018-April 2019) were retrieved. Data included demographics, laboratory tests (HBsAg, CBC, liver biochemical profile, creatinine, AFP, HbA1c, and viral load), FIB-4 score calculation, and abdominal ultrasound results. RESULTS Results of 297,965 patients showed that HBsAg was positive in 2,347 (0.8%) patients. Patients with HBV/HCV were 57% females and had a mean age of 51 ± 13 years. Patients with positive HBsAg showed significantly more tobacco consumption, intravenous drug abuse, hypertension, and diabetes. No significant difference was noted in HCV viremia between patients with HCV and those with HBV/HCV. Only 14% of patients with HBV/HCV had cirrhosis compared with the 9% of those with HCV; two of them had HCC. CONCLUSION Although Egypt has a heavy HCV burden, the overall prevalence of HBV is low among patients with HCV infection. Comorbid conditions seem to favor coinfection.
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Affiliation(s)
- Hadeel Gamal Eldeen
- Cairo University, Department of Endemic Hepatology, Gastroenterology and Infectious Diseases, Cairo, Egypt.
| | - Mohamed Hassany
- National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - Wafaa Elakel
- Cairo University, Department of Endemic Hepatology, Gastroenterology and Infectious Diseases, Cairo, Egypt
| | - Mohamed AbdAllah
- National Research Center, Medical Research Division, Cairo, Egypt
| | - Wael Abdel-Razek
- National Liver Institute, Menofia University, Shebeen El-Kom, Department of Hepatology, Cairo, Egypt
| | - Yehia Elshazly
- Ain Shams University, Department of Internal Medicine, Cairo, Egypt
| | - Hany M Dabbous
- Ain Shams University, Department of Tropical Medicine, Cairo, Egypt
| | | | - Magdy El-Serafy
- Cairo University, Department of Endemic Hepatology, Gastroenterology and Infectious Diseases, Cairo, Egypt
| | - Imam Waked
- National Liver Institute, Menofia University, Shebeen El-Kom, Department of Hepatology, Cairo, Egypt
| | - Gamal Esmat
- Cairo University, Department of Endemic Hepatology, Gastroenterology and Infectious Diseases, Cairo, Egypt
| | - Wahid Doss
- Cairo University, Department of Endemic Hepatology, Gastroenterology and Infectious Diseases, Cairo, Egypt
| | - Ahmed Hashem
- Cairo University, Department of Endemic Hepatology, Gastroenterology and Infectious Diseases, Cairo, Egypt
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Ebada HE, Montasser MF, Abdelghaffar MF, Bahaa MM, Elbaset HSA, Sakr MA, Dabbous HM, Montasser IF, Hassan MS, Aboelmaaty ME, Elmeteini MS. Ascites post-living donor liver transplantation: Risk factors and outcome. Journal of Liver Transplantation 2022. [DOI: 10.1016/j.liver.2022.100112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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4
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Hassan EA, Makhlouf NA, Ibrahim ME, Dabbous HM, Salah MA, Aboalam HS, Mohamed MZ, Fadel BA, Salama MAR. Impact of Sarcopenia on Short-Term Complications and Survival After Liver Transplant. EXP CLIN TRANSPLANT 2022; 20:917-924. [DOI: 10.6002/ect.2022.0293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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5
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Salah M, Dabbous HM, Montasser IF, Bahaa M, Abdou AMH, Elmeteini MS. Covid-19 in recipients of living donor liver transplantation: a worse or an equivalent outcome? QJM 2022; 115:69-76. [PMID: 34963013 PMCID: PMC9383128 DOI: 10.1093/qjmed/hcab329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/17/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (Covid-19) pandemic is representing a massive burden to the community with the new virus. There is few data regarding Covid-19 in liver transplant patients. Concerns were raised regarding the course of the disease in transplanted patients due to immunosuppression and risk of hepatic injuries. AIM To describe the outcomes of Covid-19 infection in recipients of living-donor liver transplantation (LDLT). METHODS Retrospective analysis of 41 recipients of LDLT diagnosed with Covid-19 by real-time PCR or CT chest criteria of Covid-19 between April 2020 and April 2021. This Cohort was derived from Ain Shams Center for Organ Transplantation database, Ain Shams Specialized Hospital, Cairo, Egypt, which is considered one of the largest centers of LDLT in the Middle East. Patients were classified to mild, moderate, severe and critics according to clinical classification released by the National Health Commission of China. RESULTS A total of 41 patients and 2 patients with reinfection were included in this cohort with mean age 54 years with 74% male and 26% female. The body mass index ranged from 19.3 to 37. About 30% were described as a mild case, 46.5% were moderate, 14% were severe and 9% were critical cases. Two cases developed infection twice. Total of 20 patients (46.5%) were managed in home isolation setting, 17 patients (39.5%) needed admission to ward, 4 patients (9%) in intermediate care unit and 2 patients (4%) admitted to intensive care unit. About 60% of cases were on room air, only 3 patients needed invasive methods, 2 patients needed face mask and 1 case needed invasive CPAP. In total, 41 patients recovered (95%) and 2 patients (5%) died; 1 was Covid related and the other one was non-Covid related. Female gender, higher BMI and hypertension were associated with severe course of the disease. CONCLUSION In the setting of LDLT, the possibilities of catching Covid-19 infection are high due to chronic immunosuppression use. Yet, the outcome of infection in term of morbidity and the needs for hospital admission or intensive care is generally matched to general population.
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Affiliation(s)
- M Salah
- Tropical Medicine Department, Ain Shams University, Cairo, Egypt
- Address correspondence to Dr M. Salah, MD, Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - H M Dabbous
- Tropical Medicine Department, Ain Shams University, Cairo, Egypt
| | - I F Montasser
- Tropical Medicine Department, Ain Shams University, Cairo, Egypt
| | - M Bahaa
- Hepatobiliary Unit, Surgical Department, Ain Shams University, Cairo, Egypt
| | - A M H Abdou
- Department of Anesthesia and Intensive Care, Ain Shams University, Abbasisa square, Greater Cairo 11591, Egypt
| | - M S Elmeteini
- Hepatobiliary Unit, Surgical Department, Ain Shams University, Cairo, Egypt
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Hashem WM, El-Sayed MH, Ahmed OA, Dabbous HM, Shaker MK, Sherief AF, Naguib MG, Ibrahim SAM, Mansour A. Microelimination of hepatitis C in patients with chronic hemolytic anemias: a single-center experience. Egypt Liver Journal 2021. [DOI: 10.1186/s43066-021-00117-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Patients with chronic hemolytic anemias (CHA) are at a high risk for transfusion-transmitted infections. Various studies in Egypt have shown a prevalence of hepatitis C virus (HCV) infection in 24–37% of those patients. Elimination of hepatitis C virus (HCV) in patients with CHA would prevent early progression of liver disease. In this study, we aimed to assess the efficacy, safety, and tolerability of sofosbuvir (SOF) and daclatasvir (DAC) in the special population of HCV-infected patients with CHA. In this prospective study, 21 consenting hepatitis C patients were recruited and treated using ribavirin-free SOF/DAC regimen for either 12 or 24 weeks according to categorization of patients into easy or hard-to-treat in accordance with the national protocols. Sustained virological response was assessed by RT-PCR for HCV-RNA at 12 weeks post-treatment (SVR12). Any treatment-related adverse events were noted.
Results
All patients were adherent to treatment with no discontinuation of therapy. SVR12 was achieved in 19 out of 21 patients (90.5%). There was a significant improvement in levels of ALT (p<0.009) after completion of therapy. On the other hand, the hemoglobin, total bilirubin, and ferritin levels showed a non-significant difference (p<0.501, p<0.542, and p<0.339, respectively). Moderate adverse events were observed in 2 out of 21 patients (9.5%), including sickling crisis and hepatic decompensation.
Conclusion
The results of this study substantiate the favorable efficacy, safety, and tolerability of ribavirin-free direct-acting antivirals (DAAs) in the special population of HCV-infected patients with CHA. Micro-elimination of HCV in special patient populations allows for pragmatic delivery of care to patients with co-morbid conditions who are in most need for treatment and allows for achievement of global elimination of HCV worldwide.
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Dabbous HM, Abd-Elsalam S, El-Sayed MH, Sherief AF, Ebeid FFS, El Ghafar MSA, Soliman S, Elbahnasawy M, Badawi R, Tageldin MA. Retraction Note to: Efficacy of favipiravir in COVID‑19 treatment: a multi‑center randomized study. Arch Virol 2021; 167:277. [PMID: 34811571 PMCID: PMC8608235 DOI: 10.1007/s00705-021-05307-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Hany M Dabbous
- Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Sherief Abd-Elsalam
- Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, El‑Giash Street, Tanta, 31527, Egypt.
| | - Manal H El-Sayed
- Faculty of Medicine, Ain Shams University Research Institute-Clinical Research Center (MASRI-CRC), Cairo, Egypt
| | - Ahmed F Sherief
- Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Fatma F S Ebeid
- Faculty of Medicine, Ain Shams University Research Institute-Clinical Research Center (MASRI-CRC), Cairo, Egypt
| | - Mohamed Samir Abd El Ghafar
- Department of Anesthesia, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Shaimaa Soliman
- Public Health and Community Medicine, Menoufia University, Menoufia, Egypt
| | - Mohamed Elbahnasawy
- Emergency Medicine and Traumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Rehab Badawi
- Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, El‑Giash Street, Tanta, 31527, Egypt
| | - Mohamed Awad Tageldin
- Department of Chest Diseases, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Abd-Elsalam S, Ahmed OA, Mansour NO, Abdelaziz DH, Salama M, Fouad MHA, Soliman S, Naguib AM, Hantera MS, Ibrahim IS, Torky M, Dabbous HM, El Ghafar MSA, Abdul-Baki EA, Elhendawy M. Remdesivir Efficacy in COVID-19 Treatment: A Randomized Controlled Trial. Am J Trop Med Hyg 2021; 106:886-890. [PMID: 34649223 PMCID: PMC8922517 DOI: 10.4269/ajtmh.21-0606] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/25/2021] [Indexed: 11/26/2022] Open
Abstract
To date, no antiviral therapy has shown proven clinical effectiveness in treating patients with COVID-19. We assessed the efficacy of remdesivir in hospitalized Egyptian patients with COVID-19. Patients were randomly assigned at a 1:1 ratio to receive either remdesivir (200 mg on the first day followed by 100 mg daily for the next 9 days intravenously infused over 30–60 minutes) in addition to standard care or standard care alone. The primary outcomes were the length of hospital stay and mortality rate. The need for mechanical ventilation was assessed as a secondary outcome. Two hundred patients (100 in each group) completed the study and were included in the final analysis. The remdesivir group showed a significantly lower median duration of hospital stay (10 days) than the control group (16 days; P < 0.001). Eleven of the patients in the remdesivir group needed mechanical ventilation compared with eight patients in the control group (P = 0.469). The mortality rate was comparable between the two groups (P = 0.602). Mortality was significantly associated with older age, elevated C-reactive protein levels, elevated D-dimer, and the need for mechanical ventilation (P = 0.039, 0.003, 0.001, and < 0.001 respectively). Remdesivir had a positive influence on length of hospital stay, but it had no mortality benefit in Egyptian patients with COVID-19. Its use, in addition to standard care including dexamethasone, should be considered, particularly in low- and middle-income countries when other effective options are scarce.
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Affiliation(s)
- Sherief Abd-Elsalam
- Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ossama Ashraf Ahmed
- Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Noha O Mansour
- Clinical Pharmacy and Pharmacy Practice Department, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
| | - Doaa H Abdelaziz
- Department of Clinical Pharmacy, The National Hepatology and Tropical Medicine Research Institute, Egypt.,Pharmacy Practice and Clinical Pharmacy Department, Faculty of Pharmacy, Future University in Egypt, Cairo, Egypt
| | - Marwa Salama
- Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | - Shaimaa Soliman
- Public Health and Community Medicine, Menoufia University, Menoufia, Egypt
| | - Ahmed Mohamed Naguib
- Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | | | | | - Hany M Dabbous
- Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Samir Abd El Ghafar
- Department of Anesthesia, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Enas A Abdul-Baki
- Biotechnology Department, Faculty of Biotechnology, Badr University, Cairo, Egypt
| | - Mohammed Elhendawy
- Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt
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F Sherief A, M Taha R, M Dabbous H, Elgaafary M, T Elganzory A, M Mahmoud M, MI Goda A, M Eltabbakh M. COVID-19 Infection in Egyptian Older Patients: Does it Differ? Act Scie Micro 2021; 4:31-37. [DOI: 10.31080/asmi.2021.04.0889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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10
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Dabbous HM, El-Sayed MH, El Assal G, Elghazaly H, Ebeid FFS, Sherief AF, Elgaafary M, Fawzy E, Hassany SM, Riad AR, TagelDin MA. Safety and efficacy of favipiravir versus hydroxychloroquine in management of COVID-19: A randomised controlled trial. Sci Rep 2021; 11:7282. [PMID: 33790308 PMCID: PMC8012649 DOI: 10.1038/s41598-021-85227-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 02/25/2021] [Indexed: 02/06/2023] Open
Abstract
Favipiravir is considered a potential treatment for COVID-19 due its efficacy against different viral infections. We aimed to explore the safety and efficacy of favipiravir in treatment of COVID-19 mild and moderate cases. It was randomized-controlled open-label interventional phase 3 clinical trial [NCT04349241]. 100 patients were recruited from 18th April till 18th May. 50 patients received favipiravir 3200 mg at day 1 followed by 600 mg twice (day 2-day 10). 50 patients received hydroxychloroquine 800 mg at day 1 followed by 200 mg twice (day 2-10) and oral oseltamivir 75 mg/12 h/day for 10 days. Patients were enrolled from Ain Shams University Hospital and Assiut University Hospital. Both arms were comparable as regards demographic characteristics and comorbidities. The average onset of SARS-CoV-2 PCR negativity was 8.1 and 8.3 days in HCQ-arm and favipiravir-arm respectively. 55.1% of those on HCQ-arm turned PCR negative at/or before 7th day from diagnosis compared to 48% in favipiravir-arm (p = 0.7). 4 patients in FVP arm developed transient transaminitis on the other hand heartburn and nausea were reported in about 20 patients in HCQ-arm. Only one patient in HCQ-arm died after developing acute myocarditis resulted in acute heart failure. Favipiravir is a safe effective alternative for hydroxychloroquine in mild or moderate COVID-19 infected patients.
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Affiliation(s)
- Hany M Dabbous
- Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Ramsis Street, Abbassia Square, Cairo, 11591, Egypt.
| | - Manal H El-Sayed
- Faculty of Medicine, Ain Shams University Research Institute-Clinical Research Centre (MASRI-CRC), Cairo, Egypt
| | | | - Hesham Elghazaly
- Faculty of Medicine, Ain Shams University Research Institute-Clinical Research Centre (MASRI-CRC), Cairo, Egypt
| | - Fatma F S Ebeid
- Faculty of Medicine, Ain Shams University Research Institute-Clinical Research Centre (MASRI-CRC), Cairo, Egypt
| | - Ahmed F Sherief
- Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Ramsis Street, Abbassia Square, Cairo, 11591, Egypt
| | - Maha Elgaafary
- Community Medicine Department, Ain Shams University, Cairo, Egypt
| | - Ehab Fawzy
- Tropical Medicine Department, Assiut University, Assiut, Egypt
| | - Sahar M Hassany
- Tropical Medicine Department, Assiut University, Assiut, Egypt
| | - Ahmed R Riad
- Tropical Medicine Department, Assiut University, Assiut, Egypt
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11
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Dabbous HM, Abd-Elsalam S, El-Sayed MH, Sherief AF, Ebeid FFS, El Ghafar MSA, Soliman S, Elbahnasawy M, Badawi R, Tageldin MA. Efficacy of favipiravir in COVID-19 treatment: a multi-center randomized study. Arch Virol 2021; 166:949-954. [PMID: 33492523 PMCID: PMC7829645 DOI: 10.1007/s00705-021-04956-9] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 11/25/2020] [Indexed: 02/07/2023]
Abstract
No specific antiviral drugs have been approved for the treatment of COVID-19. This study aimed to evaluate the efficacy of favipiravir in treatment of COVID-19. This was a multicenter randomized controlled study including 96 patients with COVID- 19 who were randomly assigned into a chloroquine (CQ) group and a favipiravir group. None of the patients in the favipiravir group needed mechanical ventilation (p = 0.129). One patient (2.3%) in the favipiravir group and two patients (4.2%) in the CQ group died (p = 1.00). Favipiravir is a promising drug for COVID-19 that decreases the hospital stay and the need for mechanical ventilation. ClinicalTrials.gov Identifier NCT04351295.
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Affiliation(s)
- Hany M Dabbous
- Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Sherief Abd-Elsalam
- Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, El-Giash Street, Tanta, 31527, Egypt.
| | - Manal H El-Sayed
- Faculty of Medicine, Ain Shams University Research Institute-Clinical Research Center (MASRI-CRC), Cairo, Egypt
| | - Ahmed F Sherief
- Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Fatma F S Ebeid
- Faculty of Medicine, Ain Shams University Research Institute-Clinical Research Center (MASRI-CRC), Cairo, Egypt
| | - Mohamed Samir Abd El Ghafar
- Department of Anesthesia, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Shaimaa Soliman
- Public Health and Community Medicine, Menoufia University, Menoufia, Egypt
| | - Mohamed Elbahnasawy
- Emergency Medicine and Traumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Rehab Badawi
- Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, El-Giash Street, Tanta, 31527, Egypt
| | - Mohamed Awad Tageldin
- Department of Chest Diseases, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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12
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Montasser IF, Dabbous HM, Salah M, Massoud Y, Ebada H, Sakr M, Atef S, Bahaa M, El Meteini M. Repeated COVID-19 infection in recipients of post-living donor liver transplantation: Two real-life cases. J Liver Transpl 2021; 1:100002. [PMID: 38620819 PMCID: PMC7845542 DOI: 10.1016/j.liver.2021.100002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/16/2020] [Accepted: 12/18/2020] [Indexed: 01/08/2023] Open
Abstract
COVID-19 is an emerging pandemic. The course and management of the disease in the liver transplant setting may be difficult due to a long-standing immunosuppressive state. In Egypt, the only available option is living donor liver transplantation (LDLT). In our centre, we have transplanted 440 livers since 2008. In this study, we report a single-centre experience with COVID-19 infection in long-term liver transplant recipients. A total of 25 recipients (5.7 %) had COVID-19 infections since March 2020. Among these recipients, two developed COVID-19 infections twice, approximately three and two months apart, respectively.
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Affiliation(s)
- I F Montasser
- Department of Tropical Medicine, Ain Shams Centre for Organ Transplantation (ASCOT), Ain Shams University, Cairo, Egypt
| | - H M Dabbous
- Department of Tropical Medicine, Ain Shams Centre for Organ Transplantation (ASCOT), Ain Shams University, Cairo, Egypt
| | - M Salah
- Department of Tropical Medicine, Ain Shams Centre for Organ Transplantation (ASCOT), Ain Shams University, Cairo, Egypt
| | - Y Massoud
- Department of Tropical Medicine, Ain Shams Centre for Organ Transplantation (ASCOT), Ain Shams University, Cairo, Egypt
| | - H Ebada
- Department of Tropical Medicine, Ain Shams Centre for Organ Transplantation (ASCOT), Ain Shams University, Cairo, Egypt
| | - M Sakr
- Department of Tropical Medicine, Ain Shams Centre for Organ Transplantation (ASCOT), Ain Shams University, Cairo, Egypt
| | - S Atef
- Department of Tropical Medicine, Ain Shams Centre for Organ Transplantation (ASCOT), Ain Shams University, Cairo, Egypt
| | - M Bahaa
- Department of Hepatobiliary Surgery & Liver Transplantation, Ain Shams Centre for Organ Transplantation (ASCOT), Ain Shams University, Cairo, Egypt
| | - M El Meteini
- Department of Hepatobiliary Surgery & Liver Transplantation, Ain Shams Centre for Organ Transplantation (ASCOT), Ain Shams University, Cairo, Egypt
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Dabbous HM, El-sayed MH, Assal GE, Elghazaly H, Ebeid FF, Sherief AF, Elgaafary M, Fawzy E, Hassany SM, Riad AR, Tageldin MA. A Randomized Controlled Study Of Favipiravir Vs Hydroxychloroquine In COVID-19 Management: What Have We Learned So Far? [DOI: 10.21203/rs.3.rs-83677/v1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Abstract
Background: Favipiravir is considered a potential treatment for COVID-19 due its efficacy against different viral infections. We aimed to explore the safety and efficacy of favipiravir in treatment of COVID-19 mild and moderate cases.Methods: A randomized-controlled open-label interventional phase 3 clinical trial [NCT04349241]. 100 patients were recruited from 18thApril till 18thMay. 50patients received favipiravir 3200mg at day1 followed by 600mg twice (day2-day10). 50patients received hydroxychloroquine 800mg at day1 followed by 200mg twice (day2- 10) and oral oseltamivir 75mg/12hour/day for 10 days. Patients were enrolled from Ain Shams University Hospital and Assiut University Hospital.Results: Both arms were comparable as regards demographic characteristics and comorbidities. The average onset of SARS-CoV-2 PCR negativity was 8.1 and 8.3 days in HCQ-arm and favipiravir-arm respectively. 55.1% of those on HCQ-arm turned PCR negative at/or before 7th day from diagnosis compared to 48% in favipiravir-arm (p=0.7). Four patients in FVP arm developed transient transaminitis on the other hand heartburn and nausea were reported in about 20 patients in HCQ-arm. Only one patient in HCQ-arm died after developing acute myocarditis resulted in acute heart failure. Conclusion: Favipiravir is a safe effective alternative for hydroxychloroquine in mild or moderate COVID-19 infected patients.
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Affiliation(s)
| | - Manal H. El-Sayed
- Faculty of Medicine Ain Shams University Research Institute-Clinical Research Centre (MASRI-CRC),Cairo, Egypt
| | | | - Hesham Elghazaly
- Faculty of Medicine Ain Shams University Research Institute-Clinical Research Centre (MASRI-CRC),Cairo, Egypt
| | - Fatma FS Ebeid
- Faculty of Medicine Ain Shams University Research Institute-Clinical Research Centre (MASRI-CRC),Cairo, Egypt
| | | | | | - Ehab Fawzy
- Faculty of Medicine, Assiut University, Assiut ,Egypt
| | | | - Ahmed R Riad
- Faculty of Medicine, Assiut University, Assiut ,Egypt
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Sakr MA, Ebada HE, Abdelkader S, Dabbous HM, Montasser IF, Bassuny AN, Massoud YM, Abdelmoaty AS. Outcome of Colonoscopic Screening in Potential Liver Transplant Candidates. Transplant Proc 2020; 52:227-232. [PMID: 32000940 DOI: 10.1016/j.transproceed.2019.10.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 10/01/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Screening for neoplastic lesions is mandatory as a part of the evaluation process of potential candidates for liver transplant (LT). This work aimed at identifying the main findings in screening colonoscopy and their risk factors. METHODS Endoscopic and pathologic findings of the biopsied lesions of 311 potential candidates for living donor liver transplant were collected and analyzed. RESULTS Colorectal polyps (8.7%) were the most common colonoscopic finding, of which 4.18% were diagnosed as adenomas. Other findings included hemorrhoids (7.7%), portal hypertensive colopathies (3.5%), angiomatous malformations (2.6%), rectal varices (1.6%), and diverticulosis (1.6%). The univariate analysis revealed that the prevalence of colonic adenoma was significant in patients 50 years and older (P = .03; odds ratio, 1.178; 95% CI, 1.016-1.365) and in patients who had hepatocellular carcinoma (P = .043; odds ratio, 6.5; 95% CI, 1.002-42.172). In the multivariate analysis, age was found to be the single best predictor of the presence of adenoma (P = .044; odds ratio, 1.178; 95% CI, 1.005-1.382). CONCLUSION We can conclude that a screening colonoscopy prior to liver donor liver transplant should be performed at least in every LT candidate 50 years or older. Colonic polyps were the most common findings on screening colonoscopy prior to LT.
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Affiliation(s)
- Mohammad A Sakr
- Ain Shams University, Department of Tropical Medicine Cairo, Abbasia, Egypt; and Ain Shams Center for Organ Transplantation, Cairo, Abbasia, Egypt
| | - Hend E Ebada
- Ain Shams University, Department of Tropical Medicine Cairo, Abbasia, Egypt; and Ain Shams Center for Organ Transplantation, Cairo, Abbasia, Egypt.
| | - Soheir Abdelkader
- Ain Shams University, Department of Tropical Medicine Cairo, Abbasia, Egypt; and Ain Shams Center for Organ Transplantation, Cairo, Abbasia, Egypt
| | - Hany M Dabbous
- Ain Shams University, Department of Tropical Medicine Cairo, Abbasia, Egypt; and Ain Shams Center for Organ Transplantation, Cairo, Abbasia, Egypt
| | - Iman F Montasser
- Ain Shams University, Department of Tropical Medicine Cairo, Abbasia, Egypt; and Ain Shams Center for Organ Transplantation, Cairo, Abbasia, Egypt
| | - Ahmed N Bassuny
- Ain Shams University, Department of Tropical Medicine Cairo, Abbasia, Egypt; and Ain Shams Center for Organ Transplantation, Cairo, Abbasia, Egypt
| | - Yasmeen M Massoud
- Ain Shams University, Department of Tropical Medicine Cairo, Abbasia, Egypt; and Ain Shams Center for Organ Transplantation, Cairo, Abbasia, Egypt
| | - Ahmed S Abdelmoaty
- Ain Shams University, Department of Tropical Medicine Cairo, Abbasia, Egypt; and Ain Shams Center for Organ Transplantation, Cairo, Abbasia, Egypt
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Sakr MA, Abdelkader SM, Ebada HE, Bassuny AN, Dabbous HM, Montasser IF, Abdelmoaty AS. Outcome of colonoscopic screening in potential liver transplant candidates. J Adv Res 2019. [DOI: 10.1016/j.jare.2019.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Sakr MA, El Gindy EM, Abdelkader NA, Ghazy MS, Dabbous HM, Shabban MM, Abdelmoaty AS, Sherief AF. Bacteremia as a predictor of early TIPS stent occlusion in Egyptian Budd Chiari Syndrome Patients. J Adv Res 2019. [DOI: 10.1016/j.jare.2019.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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A Sakr M, Abdelhakam SM, Dabbous HM, Abdelmoaty AS, Ebada HE, Al-Banna WM, Ghazy MS, Aboelmaaty ME, Eldorry AK. Pattern of Vascular Involvement in Egyptian Patients with Budd-Chiari Syndrome: Relation to Etiology and Impact on Clinical Presentation. Ann Hepatol 2018; 17:638-644. [PMID: 29893705 DOI: 10.5604/01.3001.0012.0933] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND AIM Budd-Chiari syndrome (BCS) is caused by hepatic venous outflow obstruction. This work aims to analyze the pattern of vascular involvement in Egyptian patients with BCS, demonstrates its relation to etiology and shows its impact on clinical presentation. MATERIAL AND METHODS The current retrospective study was conducted at The Tropical Medicine Department, Ain Shams University on one hundred Egyptian patients with confirmed diagnosis of primary BCS who were presented to the Budd-Chiari Study Group (BCSG) from April 2014 to May 2016 by collecting clinical, laboratory and radiological data from their medical records. RESULTS Isolated hepatic vein occlusion (HVO) was the most common pattern of vascular involvement (43%), followed by combined HVO and inferior vena cava (IVC) compression by enlarged caudate lobe (32%), then combined HVO and IVC stenosis/webs (21%), and lastly isolated IVC occlusion (4%). Ascites was more significantly encountered in BCS patients with HVO than in those with isolated inferior vena cava (IVC) occlusion and patent HVs (P = 0.005). Abdominal pain was significantly encountered in patients with occluded three major HVs (P = 0.044). Behcet's disease was significantly detected in isolated IVC occlusion. Protein C deficiency was significantly detected in patients with combined HVO and IVC compression. CONCLUSION Isolated HVs occlusion was the most common pattern of vascular involvement in Egyptian patients with primary BCS. Vascular pattern of involvement affected the clinical presentation and was related to the underlying thrombophilia in those patients.
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Affiliation(s)
- Mohammad A Sakr
- Department of Tropical Medicine, Ain Shams University, Cairo, Abbasia, Egypt
| | - Sara M Abdelhakam
- Department of Tropical Medicine, Ain Shams University, Cairo, Abbasia, Egypt
| | - Hany M Dabbous
- Department of Tropical Medicine, Ain Shams University, Cairo, Abbasia, Egypt
| | - Ahmed S Abdelmoaty
- Department of Tropical Medicine, Ain Shams University, Cairo, Abbasia, Egypt
| | - Hend E Ebada
- Department of Tropical Medicine, Ain Shams University, Cairo, Abbasia, Egypt
| | - Wael M Al-Banna
- Department of Tropical Medicine, Ain Shams University, Cairo, Abbasia, Egypt
| | - Mohamed S Ghazy
- Department of Radiodiagnosis and Interventional Radiology, Ain Shams University, Cairo, Abbasia, Egypt
| | - Mohamed E Aboelmaaty
- Department of Radiodiagnosis and Interventional Radiology, Ain Shams University, Cairo, Abbasia, Egypt
| | - Ahmed K Eldorry
- Department of Radiodiagnosis and Interventional Radiology, Ain Shams University, Cairo, Abbasia, Egypt
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Shaker MK, Montasser IF, Sakr M, Elgharib M, Dabbous HM, Ebada H, Dorry AE, Bahaa M, Meteini ME. Efficacy of loco-regional treatment for hepatocellular carcinoma prior to living donor liver transplantation: a report from a single center in Egypt. J Hepatocell Carcinoma 2018. [PMID: 29520343 PMCID: PMC5833771 DOI: 10.2147/jhc.s147098] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background and aim The number of loco-regional therapies (LRTs) for hepatocellular carcinoma (HCC) has increased dramatically during the past decade, bridging or downstaging patients on the waiting list for liver transplantation. This study aimed to analyze the outcomes of LRTs prior to living donor liver transplantation in patients with HCC. Methods Sixty-two HCC patients received living donor liver transplantation at Ain Shams Center for Organ Transplantation over a 2-year period. Data from 29 HCC patients were analyzed. Twenty patients (68.97%) met the Milan Criteria and 4 patients (13.8%) exceeded the Milan Criteria, but met the University of California, San Francisco Criteria. Five patients (17.2%) exceeded the University of California, San Francisco Criteria. All patients underwent preoperative LRTs. The protocol of bridging/downstaging, methods, duration of follow-up, the number of patients who were successfully downstaged before liver transplantation (LT), and their outcomes after LT were recorded. Results There was a decrease in the mean overall size of focal lesions (from mean 5.46 to 4.11 cm) in the last abdominal computed tomography (CT) scan after LRT (p=0.0018). Discrepancies between the radiological findings and histopathology were as follows: in 16 patients (55.17%) the CT findings were consistent with the histopathological examination of the explanted liver. Underestimated tumor stage was documented in 10 patients (34.48%), and was overestimated by CT scan findings in 3 patients (10.34%). The 1-year survival rate was 93%. No patient had HCC recurrence after median follow-up of 21 months (range 1–46 months). Conclusion These results encouraged tumor bridging/downstaging as a potential treatment option among carefully selected patients with HCC beyond conventional criteria for LT. Further studies on a large number of patients are necessary.
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Affiliation(s)
| | | | | | | | | | | | - Ahmed El Dorry
- Department of Radiodiagnosis and Interventional Radiology
| | - Mohamed Bahaa
- Department of Hepatobiliary Surgery and Liver Transplantation, Ain Shams Center for Organ Transplantation (ASCOT), Ain Shams University, Cairo, Egypt
| | - Mahmoud El Meteini
- Department of Hepatobiliary Surgery and Liver Transplantation, Ain Shams Center for Organ Transplantation (ASCOT), Ain Shams University, Cairo, Egypt
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Dabbous HM, Montasser IF, Sakr MA, Refai R, Sayam M, Abdelmonem A, Sayed H, F. Abdelghafar M, Bahaa M, S. Elmeteini M. Safety, Efficacy, and Tolerability of Sofosbuvir and Ribavirin in Management of Recurrent Hepatitis C Virus Genotype 4 After Living Donor Liver Transplant in Egypt: What Have We Learned so far? Hepat Mon 2016; 16:e35339. [PMID: 27330537 PMCID: PMC4912692 DOI: 10.5812/hepatmon.35339] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 02/02/2016] [Accepted: 04/12/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Recurrence of HCV after living donor liver transplant (LDLT) is nearly universal, with almost one third of recipients developing cirrhosis and graft failure within 5 years after LDLT. Different studies have been published on the effect of sofosbuvir after liver transplantation on recurrent HCV with different genotypes. OBJECTIVES The aim of this study was to evaluate the efficacy, safety, and tolerability of sofosbuvir and ribavirin in LDLT recipients with recurrent HCV genotype 4. PATIENTS AND METHODS Thirty-nine Egyptian LDLT recipients were treated for recurrent HCV after LDLT with nucleos(t)ide analog NS5B polymerase inhibitor, sofosbuvir, and ribavirin without pegylated interferon for 6 months (November 2014 to June 2015) in this intention-to-treat analysis. RESULTS One recipient died 1 week after starting the treatment, but the remaining 38 patients completed 24 weeks of treatment and were then followed for 12 weeks after end of treatment (EOT). The sustained virological response (SVR) at week 12 after EOT was achieved in 76% (29/38) of recipients. SVR was significantly higher in treatment-naïve patients and in recipients with a low stage of fibrosis. Only 2 (5%) recipients developed severe pancytopenia and acute kidney injury. CONCLUSIONS We recommend initiating treatment as soon as possible after liver transplantation with newer combinations, such as ledipasvir/sofosbuvir or sofosbuvir/simeprevir, rather than sofosbuvir with Ribavirin, to achieve higher rates of SVR.
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Affiliation(s)
- Hany M. Dabbous
- Ain Shams Center for Organ Transplant, Faculty of Medicine, Ain Shams University, Cairo, Egypt
- Corresponding Author: Hany M. Dabbous, Ain Shams Center for Organ Transplant, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Tel: +20-223809247, E-mail:
| | - Iman F. Montasser
- Ain Shams Center for Organ Transplant, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed A. Sakr
- Ain Shams Center for Organ Transplant, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Rasha Refai
- Ain Shams Center for Organ Transplant, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Moataz Sayam
- Ain Shams Center for Organ Transplant, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed Abdelmonem
- Ain Shams Center for Organ Transplant, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hany Sayed
- Ain Shams Center for Organ Transplant, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed F. Abdelghafar
- Ain Shams Center for Organ Transplant, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Bahaa
- Ain Shams Center for Organ Transplant, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mahmoud S. Elmeteini
- Ain Shams Center for Organ Transplant, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Hamidian Jahromi A, Jafarimehr E, Dabbous HM, Chu Q, D'Agostino H, Shi R, Wellman GP, Zibari GB, Shokouh-Amiri H. Curative resection of pancreatic adenocarcinoma with major venous resection/repair is safe procedure but will not improve survival. JOP 2014; 15:433-441. [PMID: 25262709 DOI: 10.6092/1590-8577/2430] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To evaluate the safety and survival benefit of combined curative resection (CR) of the pancreas and major venous resection in the management of borderline resectable pancreatic adenocarcinoma. METHODS In this IRB approved retrospective cohort study, patients who had pancreatic surgery (n=274) between 1998-2012 were reviewed. One hundred and seventy-five patients had malignant causes, of which 119 underwent CR. One hundred and two patients who did not require venous resection/repair (Group-I) were compared with 17 patients who had major vascular involvement (portal-vein/superior-mesenteric-vein) and underwent a vascular resection/repair (Group-II) during the CR. Demographics, operative and follow-up data were reviewed. RESULT Type of the operations were: standard Whipple (n=53), pylorus-sparing-Whipple (n=41), total pancreatectomy (n=11), and distal pancreatectomy (n=13). In Group-II, venous involvement was excised and primarily repaired (n=12), or repaired using other veins (n=4) or a synthetic patch (n=1). Group-II had a significantly larger tumor size and more perineural invasion and peripancreatic soft tissue involvement (P<0.05). While complication rate, margin status, and duration of stay were not different between the groups, the median-overall-survival was higher for Group-I (15.34 months) than Group-II patients (7.18 months) (P=0.003). CONCLUSION Pancreatic CR requiring intra-operative venous resection/repair is feasible and safe, but the survival of the patients who have pancreatic adenocarcinoma with venous involvement is poor irrespective of a successful venous resection.
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Saleh MA, Dabbous HM, El Missiri AM. Percutaneous intervention averted the need for liver transplantation. Egypt Heart J 2012. [DOI: 10.1016/j.ehj.2012.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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