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Papers by Mohamed Sharaf-Eldin

The Lancet Gastroenterology & Hepatology, 2020

With the increasing prevalence of obesity and type 2 diabetes, fatty liver disease associated wit... more With the increasing prevalence of obesity and type 2 diabetes, fatty liver disease associated with metabolic dysfunction is a global health problem, especially because it is one of the earliest consequences of obesity and it precedes diabetes development. Fatty liver disease associated with metabolic dysfunction is of particular concern in the Middle East and north Africa, where its prevalence is greater than that in the rest of the world. Despite the magnitude of the problem, no regional guidelines have been developed to address this disease. This Review describes suggestions of redefining fatty liver disease associated with metabolic dysfunction, including its terminology and criteria for diagnosis. Experts have raised serious concerns on the current nomenclature, which labels the disease as non-alcoholic fatty liver disease (NAFLD), and its diagnostic criteria. The panel reached a consensus that the disease should be renamed as metabolicassociated fatty liver disease (MAFLD) and that the disease should be diagnosed by positive criteria. The aim is now to work with authorities across the region to implement these proposed changes and reflect them in health-care policy and to improve health care for patients in this region.

Infectious Disorders - Drug Targets, 2020

Objective: To study the hemodynamic changes of hepatic & renal vessels in systemic bacterial infe... more Objective: To study the hemodynamic changes of hepatic & renal vessels in systemic bacterial infection with fever in HCV related cirrhosis with possible complications. Methods: Three groups of patients with systemic bacterial infection with fever were included in the study; group І included 15 patients with decompensated cirrhosis, group ІІ included 15 patients with compensated cirrhosis and group ІІІ included 10 patients without liver affection. Laboratory parameters and Doppler US of hepatic and renal vessels were evaluated during and after subsidence of fever in all patients. Results: Forty patients were enrolled in this prospective study. There were 22 male and 18 female patients. We found that the direction of blood flow in the portal and splenic veins was hepatopetal and the veins were non pulsatile in all cases with no change during and after subsidence of infection. There was no significant difference in portal or splenic vein diameters during and after subsidence of infecti...

Archives of virology, Jan 5, 2017

Egypt has the highest hepatitis C virus (HCV) prevalence in the world. Sofosbuvir is a new highly... more Egypt has the highest hepatitis C virus (HCV) prevalence in the world. Sofosbuvir is a new highly effective drug for treatment of HCV infection. Compared to previous treatments, sofosbuvir-based regimens provide a higher cure rate, fewer side effects, and a two- to fourfold reduced duration of therapy. The aim of this study was to evaluate the antiviral efficacy, safety, and tolerability of sofosbuvir plus ribavirin in Egyptian patients with liver cirrhosis due to chronic HCV infection. We studied 2400 cirrhotic Egyptian patients with chronic HCV infection who were treated with dual therapy with sofosbuvir and ribavirin for 24 weeks. Efficacy was determined by assessment of serum HCV RNA. Any adverse events during treatment were recorded. Two thousand four hundred cirrhotic Egyptian patients with chronic HCV infection treated with sofosbuvir and ribavirin for 24 weeks were enrolled in the study. The mean age of the studied group (± SD) was 53.9 ± 6.5 years, 1549 (64.54%) were males,...

Gastroenterology Research and Practice, 2016

Background and Aims. Treatment of hepatic hydrothorax is a clinical challenge. Chest tube inserti... more Background and Aims. Treatment of hepatic hydrothorax is a clinical challenge. Chest tube insertion for hepatic hydrothorax is associated with high complication rates. We assessed the use of pigtail catheter as a safe and practical method for treatment of recurrent hepatic hydrothorax as it had not been assessed before in a large series of patients.Methods. This study was conducted on 60 patients admitted to Tanta University Hospital, Egypt, suffering from recurrent hepatic hydrothorax. The site of pigtail catheter insertion was determined by ultrasound guidance under complete aseptic measures and proper local anesthesia. Insertion was done by pushing the trocar and catheter until reaching the pleural cavity and then the trocar was withdrawn gradually while inserting the catheter which was then connected to a collecting bag via a triple way valve.Results. The use of pigtail catheter was successful in pleural drainage in 48 (80%) patients with hepatic hydrothorax. Complications were ...

Egyptian Liver Journal, 2014

Background/Aim Hepatocellular carcinoma (HCC) is one of the major complications of liver cirrhosi... more Background/Aim Hepatocellular carcinoma (HCC) is one of the major complications of liver cirrhosis. Radiofrequency ablation (RFA) is the treatment of choice for patients with an early-stage HCC who are not candidates for surgical management; however, it is associated with a recurrence rate as high as 15-30% after 1 year. The aim of this study was to analyze the risk factors for HCC recurrence in Egyptian patients after RFA. Patients and methods This study was conducted on a cohort of HCC patients presented to three large referral centers for management of HCC in Egypt from November 2009 to January 2011. Only patients with an early-stage HCC (BCLC stage A), eligible for RFA, were included in the analysis and followed up for a period of 1 year. Patient and tumorrelated risk factors associated with recurrence were studied. Statistical analysis was performed using SPSS software. Forty-five patients were included in this study and classified into two groups: group I included patients who developed recurrence during follow-up (n = 30, 66.6%) and group II included patients who did not show any recurrence during follow-up (n = 15, 33.3%). Results The risk factors associated with recurrence included smoking (70% in group I vs. 40% in group II, P = 0.015), hepatomegaly (50% in group I vs. 40% in group II, P = 0.001), splenomegaly (90% in group I vs. 53.3% in group II, P = 0.001), heterogeneous liver (30% in group I vs. 6.66% in group II, P = 0.001), bilobar involvement (20% in group I vs. 6.66% in group II, P = 0.001), and tumors in contact with hepatic capsule (20% in group I vs. 6.66% in group II, P = 0.017). Conclusion Hepatomegaly, liver heterogeneity, and splenomegaly (a sign of portal hypertension) together with the tumor factors such as large size, bilobar involvement, and proximity to liver capsule were the factors that showed a significant association with tumor recurrence in this study.

Keywords: AflatoxinB1; Hepatocellular carcinoma (HCC); Fungal toxins. (ClinicalTrials.gov Identif... more Keywords: AflatoxinB1; Hepatocellular carcinoma (HCC); Fungal toxins. (ClinicalTrials.gov Identifier: NCT02461966). Background and Aim: The burden of hepatocellular carcinoma (HCC) has been increasing in Egypt. This fact raises the question, does the high prevalence of HCC in Egypt is related only to HCV? or is it augmented by AFB1 exposure in our patients? The aim of this study was to identify the role of aflatoxin as an environmental risk factor attributable to liver cancer in Nile delta in Egypt. Patients and Methods: This cross sectional study was carried out in tropical medicine department in Tanta university hospital on 160 patients with HCC, 80 cirrhotic patients. Sixty individuals were invited to share in the study as a control group. All patients and control were evaluated for age, sex, residence, occupation, viral markers, liver functions and serum level of aflatoxinB1. Results: Aflatoxin level in serum was significantly higher in HCC patients when compared to cirrhotics a...

International Journal of TROPICAL DISEASE & Health, 2021

Background: Hepatitis C virus (HCV) infection is a major cause of chronic liver disease. Chronic ... more Background: Hepatitis C virus (HCV) infection is a major cause of chronic liver disease. Chronic HCV infection is associated with development of insulin resistance and therefore type 2 Diabetes mellitus (T2DM), it is also associated with hepatic steatosis and hypocholesterolemia. The treatment by Direct Acting Antivirals (DAAs) leads to sustained virological response (SVR) in almost all infected patients and decreases liver-related as well as all-cause mortality in these patients. The evidence for the effect of DAAs therapy on T2DM is quite conflicting. Some studies agreed with the glucometabolic amelioration induced by the Sustained Virological Response (SVR) but other studies disagreed with this hypothesis. The aim of the work was to evaluate glucose and Lipid Profile changes in hepatitis C patients at 12 weeks post treatment (SVR12) by Direct Acting Antivirals Therapy. Methods: This prospective study was carried out on 80 chronic HCV infected patients who are treatment naïve and ...

Archives of virology, Jan 5, 2017

Egypt has the highest hepatitis C virus (HCV) prevalence in the world. Sofosbuvir is a new highly... more Egypt has the highest hepatitis C virus (HCV) prevalence in the world. Sofosbuvir is a new highly effective drug for treatment of HCV infection. Compared to previous treatments, sofosbuvir-based regimens provide a higher cure rate, fewer side effects, and a two- to fourfold reduced duration of therapy. The aim of this study was to evaluate the antiviral efficacy, safety, and tolerability of sofosbuvir plus ribavirin in Egyptian patients with liver cirrhosis due to chronic HCV infection. We studied 2400 cirrhotic Egyptian patients with chronic HCV infection who were treated with dual therapy with sofosbuvir and ribavirin for 24 weeks. Efficacy was determined by assessment of serum HCV RNA. Any adverse events during treatment were recorded. Two thousand four hundred cirrhotic Egyptian patients with chronic HCV infection treated with sofosbuvir and ribavirin for 24 weeks were enrolled in the study. The mean age of the studied group (± SD) was 53.9 ± 6.5 years, 1549 (64.54%) were males,...

Hospital pharmacy, 2017

Background: Egypt has the largest hepatitis C virus (HCV) epidemic worldwide. Sofosbuvir is an an... more Background: Egypt has the largest hepatitis C virus (HCV) epidemic worldwide. Sofosbuvir is an antiviral drug acting by inhibition of the HCV NS5B polymerase. It has shown high efficacy in combination with several other drugs and has a low reported rate of side effects. Objective: The aim of this prospective cohort study was to assess the safety of sofosbuvir-based treatment regimens used to treat chronic hepatitis C infections and to detect any side effects of sofosbuvir not previously reported. Methods: We studied treatment side effects in 3,000 patients with chronic HCV infection treated with sofosbuvir and ribavirin for 24 weeks or treated by pegylated interferon, sofosbuvir, and ribavirin triple therapy for 12 weeks. The endpoint of the study was the end of treatment. Results: Hyperbilirubinemia occurred frequently during treatment in both groups. Treatment was discontinued in 72 cases due to hepatic decompensation and drug complications; 8 of the cases had deep vein thrombosis...

The Lancet Gastroenterology & Hepatology, 2020

With the increasing prevalence of obesity and type 2 diabetes, fatty liver disease associated wit... more With the increasing prevalence of obesity and type 2 diabetes, fatty liver disease associated with metabolic dysfunction is a global health problem, especially because it is one of the earliest consequences of obesity and it precedes diabetes development. Fatty liver disease associated with metabolic dysfunction is of particular concern in the Middle East and north Africa, where its prevalence is greater than that in the rest of the world. Despite the magnitude of the problem, no regional guidelines have been developed to address this disease. This Review describes suggestions of redefining fatty liver disease associated with metabolic dysfunction, including its terminology and criteria for diagnosis. Experts have raised serious concerns on the current nomenclature, which labels the disease as non-alcoholic fatty liver disease (NAFLD), and its diagnostic criteria. The panel reached a consensus that the disease should be renamed as metabolicassociated fatty liver disease (MAFLD) and that the disease should be diagnosed by positive criteria. The aim is now to work with authorities across the region to implement these proposed changes and reflect them in health-care policy and to improve health care for patients in this region.

Infectious Disorders - Drug Targets, 2020

Objective: To study the hemodynamic changes of hepatic & renal vessels in systemic bacterial infe... more Objective: To study the hemodynamic changes of hepatic & renal vessels in systemic bacterial infection with fever in HCV related cirrhosis with possible complications. Methods: Three groups of patients with systemic bacterial infection with fever were included in the study; group І included 15 patients with decompensated cirrhosis, group ІІ included 15 patients with compensated cirrhosis and group ІІІ included 10 patients without liver affection. Laboratory parameters and Doppler US of hepatic and renal vessels were evaluated during and after subsidence of fever in all patients. Results: Forty patients were enrolled in this prospective study. There were 22 male and 18 female patients. We found that the direction of blood flow in the portal and splenic veins was hepatopetal and the veins were non pulsatile in all cases with no change during and after subsidence of infection. There was no significant difference in portal or splenic vein diameters during and after subsidence of infecti...

Archives of virology, Jan 5, 2017

Egypt has the highest hepatitis C virus (HCV) prevalence in the world. Sofosbuvir is a new highly... more Egypt has the highest hepatitis C virus (HCV) prevalence in the world. Sofosbuvir is a new highly effective drug for treatment of HCV infection. Compared to previous treatments, sofosbuvir-based regimens provide a higher cure rate, fewer side effects, and a two- to fourfold reduced duration of therapy. The aim of this study was to evaluate the antiviral efficacy, safety, and tolerability of sofosbuvir plus ribavirin in Egyptian patients with liver cirrhosis due to chronic HCV infection. We studied 2400 cirrhotic Egyptian patients with chronic HCV infection who were treated with dual therapy with sofosbuvir and ribavirin for 24 weeks. Efficacy was determined by assessment of serum HCV RNA. Any adverse events during treatment were recorded. Two thousand four hundred cirrhotic Egyptian patients with chronic HCV infection treated with sofosbuvir and ribavirin for 24 weeks were enrolled in the study. The mean age of the studied group (± SD) was 53.9 ± 6.5 years, 1549 (64.54%) were males,...

Gastroenterology Research and Practice, 2016

Background and Aims. Treatment of hepatic hydrothorax is a clinical challenge. Chest tube inserti... more Background and Aims. Treatment of hepatic hydrothorax is a clinical challenge. Chest tube insertion for hepatic hydrothorax is associated with high complication rates. We assessed the use of pigtail catheter as a safe and practical method for treatment of recurrent hepatic hydrothorax as it had not been assessed before in a large series of patients.Methods. This study was conducted on 60 patients admitted to Tanta University Hospital, Egypt, suffering from recurrent hepatic hydrothorax. The site of pigtail catheter insertion was determined by ultrasound guidance under complete aseptic measures and proper local anesthesia. Insertion was done by pushing the trocar and catheter until reaching the pleural cavity and then the trocar was withdrawn gradually while inserting the catheter which was then connected to a collecting bag via a triple way valve.Results. The use of pigtail catheter was successful in pleural drainage in 48 (80%) patients with hepatic hydrothorax. Complications were ...

Egyptian Liver Journal, 2014

Background/Aim Hepatocellular carcinoma (HCC) is one of the major complications of liver cirrhosi... more Background/Aim Hepatocellular carcinoma (HCC) is one of the major complications of liver cirrhosis. Radiofrequency ablation (RFA) is the treatment of choice for patients with an early-stage HCC who are not candidates for surgical management; however, it is associated with a recurrence rate as high as 15-30% after 1 year. The aim of this study was to analyze the risk factors for HCC recurrence in Egyptian patients after RFA. Patients and methods This study was conducted on a cohort of HCC patients presented to three large referral centers for management of HCC in Egypt from November 2009 to January 2011. Only patients with an early-stage HCC (BCLC stage A), eligible for RFA, were included in the analysis and followed up for a period of 1 year. Patient and tumorrelated risk factors associated with recurrence were studied. Statistical analysis was performed using SPSS software. Forty-five patients were included in this study and classified into two groups: group I included patients who developed recurrence during follow-up (n = 30, 66.6%) and group II included patients who did not show any recurrence during follow-up (n = 15, 33.3%). Results The risk factors associated with recurrence included smoking (70% in group I vs. 40% in group II, P = 0.015), hepatomegaly (50% in group I vs. 40% in group II, P = 0.001), splenomegaly (90% in group I vs. 53.3% in group II, P = 0.001), heterogeneous liver (30% in group I vs. 6.66% in group II, P = 0.001), bilobar involvement (20% in group I vs. 6.66% in group II, P = 0.001), and tumors in contact with hepatic capsule (20% in group I vs. 6.66% in group II, P = 0.017). Conclusion Hepatomegaly, liver heterogeneity, and splenomegaly (a sign of portal hypertension) together with the tumor factors such as large size, bilobar involvement, and proximity to liver capsule were the factors that showed a significant association with tumor recurrence in this study.

Keywords: AflatoxinB1; Hepatocellular carcinoma (HCC); Fungal toxins. (ClinicalTrials.gov Identif... more Keywords: AflatoxinB1; Hepatocellular carcinoma (HCC); Fungal toxins. (ClinicalTrials.gov Identifier: NCT02461966). Background and Aim: The burden of hepatocellular carcinoma (HCC) has been increasing in Egypt. This fact raises the question, does the high prevalence of HCC in Egypt is related only to HCV? or is it augmented by AFB1 exposure in our patients? The aim of this study was to identify the role of aflatoxin as an environmental risk factor attributable to liver cancer in Nile delta in Egypt. Patients and Methods: This cross sectional study was carried out in tropical medicine department in Tanta university hospital on 160 patients with HCC, 80 cirrhotic patients. Sixty individuals were invited to share in the study as a control group. All patients and control were evaluated for age, sex, residence, occupation, viral markers, liver functions and serum level of aflatoxinB1. Results: Aflatoxin level in serum was significantly higher in HCC patients when compared to cirrhotics a...

International Journal of TROPICAL DISEASE & Health, 2021

Background: Hepatitis C virus (HCV) infection is a major cause of chronic liver disease. Chronic ... more Background: Hepatitis C virus (HCV) infection is a major cause of chronic liver disease. Chronic HCV infection is associated with development of insulin resistance and therefore type 2 Diabetes mellitus (T2DM), it is also associated with hepatic steatosis and hypocholesterolemia. The treatment by Direct Acting Antivirals (DAAs) leads to sustained virological response (SVR) in almost all infected patients and decreases liver-related as well as all-cause mortality in these patients. The evidence for the effect of DAAs therapy on T2DM is quite conflicting. Some studies agreed with the glucometabolic amelioration induced by the Sustained Virological Response (SVR) but other studies disagreed with this hypothesis. The aim of the work was to evaluate glucose and Lipid Profile changes in hepatitis C patients at 12 weeks post treatment (SVR12) by Direct Acting Antivirals Therapy. Methods: This prospective study was carried out on 80 chronic HCV infected patients who are treatment naïve and ...

Archives of virology, Jan 5, 2017

Egypt has the highest hepatitis C virus (HCV) prevalence in the world. Sofosbuvir is a new highly... more Egypt has the highest hepatitis C virus (HCV) prevalence in the world. Sofosbuvir is a new highly effective drug for treatment of HCV infection. Compared to previous treatments, sofosbuvir-based regimens provide a higher cure rate, fewer side effects, and a two- to fourfold reduced duration of therapy. The aim of this study was to evaluate the antiviral efficacy, safety, and tolerability of sofosbuvir plus ribavirin in Egyptian patients with liver cirrhosis due to chronic HCV infection. We studied 2400 cirrhotic Egyptian patients with chronic HCV infection who were treated with dual therapy with sofosbuvir and ribavirin for 24 weeks. Efficacy was determined by assessment of serum HCV RNA. Any adverse events during treatment were recorded. Two thousand four hundred cirrhotic Egyptian patients with chronic HCV infection treated with sofosbuvir and ribavirin for 24 weeks were enrolled in the study. The mean age of the studied group (± SD) was 53.9 ± 6.5 years, 1549 (64.54%) were males,...

Hospital pharmacy, 2017

Background: Egypt has the largest hepatitis C virus (HCV) epidemic worldwide. Sofosbuvir is an an... more Background: Egypt has the largest hepatitis C virus (HCV) epidemic worldwide. Sofosbuvir is an antiviral drug acting by inhibition of the HCV NS5B polymerase. It has shown high efficacy in combination with several other drugs and has a low reported rate of side effects. Objective: The aim of this prospective cohort study was to assess the safety of sofosbuvir-based treatment regimens used to treat chronic hepatitis C infections and to detect any side effects of sofosbuvir not previously reported. Methods: We studied treatment side effects in 3,000 patients with chronic HCV infection treated with sofosbuvir and ribavirin for 24 weeks or treated by pegylated interferon, sofosbuvir, and ribavirin triple therapy for 12 weeks. The endpoint of the study was the end of treatment. Results: Hyperbilirubinemia occurred frequently during treatment in both groups. Treatment was discontinued in 72 cases due to hepatic decompensation and drug complications; 8 of the cases had deep vein thrombosis...