Search

Abstract Introduction It had been evident that non‐alcoholic fatty liver disease (NAFLD) is the new era epidemic. Despite emergence of many drugs on the pipeline that considered candidates to cure NAFLD/NASH, the critical need for defining the cohort liable to fibrosis progression is yet unmet. Aim Evaluate ABCA1 (rs1800977) genotyping as a noninvasive predictor of liver fibrosis severity. Materials and Methods This study included 118 liver biopsy‐proven NAFLD‐patients. According to Metavir‐fibrosis‐staging, cases were divided to early fibrosis (74 cases), and 44 cases with significant fibrosis (>F2), added to 49 healthy control subjects. All patients were subjected to liver function tests, lipids profile, triglyceride TG index, and hepatic steatosis index (HSI) and real‐time PCR ABCA1 SNP (rs1800977). Results Significant differences in transaminases (p > .05), albumin (p

Abstract Background Spontaneous bacterial peritonitis (SBP) is an ascitic fluid infection in patients with liver cirrhosis in the absence of surgical causes. The drop of the ascitic fluid polymorphonuclear leukocyte count (AFPC) ≥25% of baseline 48h post-start of antibiotics is a predictor of antibiotic response. This study was designed to compare the diagnostic accuracy of AFPC 24h of antibiotic to the standard 48h. Three hundred ninety-nine SBP patients were classified into 2 groups. Group I (31.1%) are patients that lacked ≥25% drop and group II (68.9%) the opposite. Results The average age was 51.99 ±11.21 years. Most patients were males (70.9%), normotensive (75.8%), non-diabetics (50.8%), and without recent intake history of proton pump inhibitors (75.8%) and B-blockers (77%). Group II patients had statistically significant (p 0.05). Group II patients compared to group I had statistically (p =0.001) lower AFPC 24h [800 (970) vs. 1100 (1700) cell/mm3], higher percent drop of the AFPC 24h [28.09 (24) vs. −10.17 (35)], and ≥25% drop [154 (90.6%) vs. 16 (9.4%)]. The 24h AFPC >980 cell/mm3 was associated with AFPC 48h non-response (AUROC =0.634, p =0.001, 58.87% sensitivity, 64.36% specificity). The 24-h AFPC percent drop >8% was associated with AFPC 48h response (AUROC =0.849, p=0.001, 85.82% sensitivity, 80.49% specificity). Conclusion Concordance of 24- and 48-h diagnostic follow-up ascitic fluid polymorphonuclear leukocyte count in the guidance of the antibiotic therapy.

Introduction The development and progression of hepatocellular carcinoma (HCC) is a multistage process involving the deregulation of genes that are crucial to cellular processes. Multiple risk factors are correlated with HCC. MicroRNA is differentially expressed in the development of different types of malignancies, including hepatic malignancy. Single nucleotide polymorphisms (SNPs) are the most common sequence variation in the human genome. SNPs in miRNAs may affect transcription, processing, or target recognition and result in malignant disease. The aim of the study was to determine the association between microRNA gene polymorphisms and the development of HCC in Egyptian patients. Material and methods This study included 200 individuals who were matched in age and sex. Tumour staging was done using the BCLC staging system. Quantification and genotyping of microRNA were performed. Results Among the 200 patients, 2 groups were described: group I included 90 HCC patients with a male majority (72.2%), and group II comprised 110 controls. Three microRNA SNPs were assayed in both patients and controls. There was a significant association between rs10061133 miR-499b and the risk of HCC. The genotypes GG or G allele were significantly associated with an increased risk of HCC (GG: OR = 2.91, 95% CI: 1.23–4.22, p = 0.013; G allele: OR = 1.79, 95% CI: 1.12–2.15, p = 0.026) compared with the genotype of AA or AG or A allele. Conclusions There is an association between the miRNA SNPs and the susceptibility to HCC, to explore some roles and mechanisms of SNPs within miRNAs in the occurrence and development of HCC.

Background: Direct acting antivirals (DAAs) are highly effective for treatment of hepatitis C (HCV) but brand products are priced beyond the means of most low and middle income countries (LMICs). Although a few DAAs are offered at reduced prices in access programs, they are still beyond affordability in limited resource settings with a large HCV infected population. Cheap generics might fill this economic need, but studies comparing their clinical efficacy to that of original products are limited. Aim: To compare efficacy of brand and generic DAAs used in the national treatment program in Egypt. Methods: HCV treatment eligible patients (n = 971) were enrolled. They were treated with 12 weeks of either sofosbuvir-daclatasvir (SOF-DCV) or SOF-ledipasvir (SOF-LDV). Ribavirin (RBV) was added to patients with cirrhosis and to SOF experienced patients. Patients with cirrhosis who were RBV intolerant were treated for 24 weeks without RBV. Results: Most patients were males (61.4%), treatment naïve (88.6%), without cirrhosis (61.7%), and the mean age was 51.3 ± 11.31 years. Baseline characteristics were not different in patients treated with brand or generic medications regarding age, liver tests, creatinine, platelets, MELD score, baseline HCV-RNA and transient elastography. Overall sustained virologic response (SVR) rate was 98.1%, which was similar for generic and brand drugs (98.2% vs. 98.1%; p = 1), and similar with both regimens used (SOF-DCV ± RBV: brand: 98.1%, generic 97.8%; p = 0.729, SOF-LDV ± RBV: brand 98.2%, generic 100%; p = 0.729). AST and ALT decreased significantly with initiation of therapy with both generic and original drugs. Conclusion: Generic and brand DAAs are equally effective for achieving SVR and improving aminotransferases. Keywords: HCV, Direct acting antivirals, Generic, Brand, Sofosbuvir, Ledipasvir, Daclatasvir, Sustained virological response