Occult hepatitis B virusinfection (OBI) is defined as the presence of HBV DNA in liver or serum of individuals who test negative for hepatitis B surface antigen (HBsAg).We aimed at determining the prevalence of OBI in patients chronically infected with HCV in Upper Egypt and to evaluate the possible impact of OBI on the progression of the liver disease. This study included 200 chronic HCV infected patients. HBV DNA was detected in the serum of 21 patients (10.5%) by nested PCR. 13 of them were positive for anti-HBc. HBV viral load ranged from 4.2-60.1 IU/ml. The percentage of cirrhotics was higher among OBI/HCV dual infection (52.4%) versus HCV mono infection (34.1%). Our study concluded that the prevalence of OBI among chronic HCV patients in Upper Egypt was 10.5%. OBI correlated with the severity of liver disease. Total anti-HBc cannot be used as a surrogate marker for detection of OBI.

Occult hepatitis B virusinfection (OBI) is defined as the presence of HBV DNA in liver or serum of individuals who test negative for hepatitis B surface antigen (HBsAg).We aimed at determining the prevalence of OBI in patients chronically infected with HCV in Upper Egypt and to evaluate the possible impact of OBI on the progression of the liver disease. This study included 200 chronic HCV infected patients. HBV DNA was detected in the serum of 21 patients (10.5%) by nested PCR. 13 of them were positive for anti-HBc. HBV viral load ranged from 4.2-60.1 IU/ml. The percentage of cirrhotics was higher among OBI/HCV dual infection (52.4%) versus HCV mono infection (34.1%). Our study concluded that the prevalence of OBI among chronic HCV patients in Upper Egypt was 10.5%. OBI correlated with the severity of liver disease. Total anti-HBc cannot be used as a surrogate marker for detection of OBI.

Occult hepatitis B virusinfection (OBI) is defined as the presence of HBV DNA in liver or serum of individuals who test negative for hepatitis B surface antigen (HBsAg).We aimed at determining the prevalence of OBI in patients chronically infected with HCV in Upper Egypt and to evaluate the possible impact of OBI on the progression of the liver disease. This study included 200 chronic HCV infected patients. HBV DNA was detected in the serum of 21 patients (10.5%) by nested PCR. 13 of them were positive for anti-HBc. HBV viral load ranged from 4.2-60.1 IU/ml. The percentage of cirrhotics was higher among OBI/HCV dual infection (52.4%) versus HCV mono infection (34.1%). Our study concluded that the prevalence of OBI among chronic HCV patients in Upper Egypt was 10.5%. OBI correlated with the severity of liver disease. Total anti-HBc cannot be used as a surrogate marker for detection of OBI.

Occult hepatitis B virusinfection (OBI) is defined as the presence of HBV DNA in liver or serum of individuals who test negative for hepatitis B surface antigen (HBsAg).We aimed at determining the prevalence of OBI in patients chronically infected with HCV in Upper Egypt and to evaluate the possible impact of OBI on the progression of the liver disease. This study included 200 chronic HCV infected patients. HBV DNA was detected in the serum of 21 patients (10.5%) by nested PCR. 13 of them were positive for anti-HBc. HBV viral load ranged from 4.2-60.1 IU/ml. The percentage of cirrhotics was higher among OBI/HCV dual infection (52.4%) versus HCV mono infection (34.1%). Our study concluded that the prevalence of OBI among chronic HCV patients in Upper Egypt was 10.5%. OBI correlated with the severity of liver disease. Total anti-HBc cannot be used as a surrogate marker for detection of OBI.

Introduction: Excess body weight can result in Diabetes mellitus, where 90% of all diabetics are type 2 (T2DM). Aim of study: To evaluate the effect of Laparoscopic Sleeve Gastrectomy (LSG) as a method of treatment of type 2 Diabetes mellitus in morbidly obese patients. Patients and methods: A prospective study was carried out on 40 diabetic morbidly obese patients who underwent LSG during 1.5 years. The pre-operative diabetic status, duration of Diabetes, body mass index, the excess weight loss percent (EWL %) at 12 and 18 months follow-up, and remission or improvement of T2DM were recorded and analyzed. Pre- and postoperative fasting blood glucose, and HbA1C were measured. In addition, Continuous Glucose Monitoring (CGM) was performed in each patient to clarify the remission of Diabetes. Results: The mean age of patients was 40.1±4.7 years. The mean preoperative BMI was 51.2±6.5 Kg/m2 . Postoperative calf DVT and bleeding occurred in 5% of cases. Diabetes resolution occurred in 87.5% of patients (n = 35), where the blood sugar control started at 3 months and reached to no medication at 6 months for 28 patients and 7 patient reached complete cure at 18 months. Diabetes was controlled on oral hypoglycemic only and a minimal dose was required in 12.5% of patients(n = 5). The EWL% was 70.2% at 12 months and 72.7% at 18 months. Conclusion: LSG resulted in total remission of T2DM in 87.5% of the patients and easy control of diabetes in 12.5% of patients, and can be considered a metabolic surgery.

BACKGROUND AND AIM: Chronic liver disease leads to reduction in health-related quality of life, particularly functional capacity. The data about the use of Six Minute Walk Test (6MWT) among cirrhotic patients are limited. The current study was done to evaluate the use of 6MWT in patients with HCV related chronic liver disease for assessing the functional capacity and to determine the correlation between the 6MWD and severity of chronic liver diseases. METHODS: This analytic cross-sectional study was carried out on 20 healthy volunteers (Group I), 40 HCV patients with early liver disease (Group II), and 40 HCV patients with liver cirrhosis (Group III). Six minute walk distance (6MWD) was calculated. RESULTS: The mean 6MWD was significantly lower in Groups II and III (325.8 ± 56.65 meter, and 131.79 ± 43.40 meter) compared to that of Group I (359.91 ± 38.63 meter) (p 0.01; p 0.001). The mean 6MWD was significantly lower in Group III compared to that of Group II (p 0.001). 6MWD was positively correlated with hemoglobin, platelets, and albumin (p 0.01). On the other hand, 6MWD was negatively correlated with bilirubin, AST, ALP, creatinine, and INR (p 0.05). There was a significant negative correlation between 6MWD and BMI in Groups II and III (p 0.05). There was no significant correlation between 6MWD and Child score or MELD score in Group III (p > 0.05). CONCLUSIONS: Six-minute walk test is a reliable indicator to measure the functional capacity for patients with HCV related chronic liver diseases.

BACKGROUND AND AIM: Chronic liver disease leads to reduction in health-related quality of life, particularly functional capacity. The data about the use of Six Minute Walk Test (6MWT) among cirrhotic patients are limited. The current study was done to evaluate the use of 6MWT in patients with HCV related chronic liver disease for assessing the functional capacity and to determine the correlation between the 6MWD and severity of chronic liver diseases. METHODS: This analytic cross-sectional study was carried out on 20 healthy volunteers (Group I), 40 HCV patients with early liver disease (Group II), and 40 HCV patients with liver cirrhosis (Group III). Six minute walk distance (6MWD) was calculated. RESULTS: The mean 6MWD was significantly lower in Groups II and III (325.8 ± 56.65 meter, and 131.79 ± 43.40 meter) compared to that of Group I (359.91 ± 38.63 meter) (p 0.01; p 0.001). The mean 6MWD was significantly lower in Group III compared to that of Group II (p 0.001). 6MWD was positively correlated with hemoglobin, platelets, and albumin (p 0.01). On the other hand, 6MWD was negatively correlated with bilirubin, AST, ALP, creatinine, and INR (p 0.05). There was a significant negative correlation between 6MWD and BMI in Groups II and III (p 0.05). There was no significant correlation between 6MWD and Child score or MELD score in Group III (p > 0.05). CONCLUSIONS: Six-minute walk test is a reliable indicator to measure the functional capacity for patients with HCV related chronic liver diseases.

AIM: This study aimed to evaluate the efficacy and safety of sofosbuvir (SOF)/ribavirin (RBV) and SOF/daclatasvir (DAC)/ RBV in Egyptian patients with hepatitis C virus (HCV)-related cirrhosis and to demonstrate the effects of these treatments on their haematological and biochemical profiles. PATIENTS AND METHODS: A prospective study was performed on 200 patients with HCV-related cirrhosis. Group 1 received SOF and RBV for 24 weeks, and Group 2 received SOF, DAC and RBV for 12 weeks. RESULTS: A sustained virological response (SVR) was achieved in 75 (75%) and 96 (96%) patients in Groups 1 and 2, respectively. The mean haemoglobin (Hb) level and platelet count decreased significantly at the end of treatment in both groups, and the percent decrease was significantly higher in Group 1 than in Group 2. The mean albumin, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels decreased significantly at the end of treatment in both groups. There was a significant increase in the mean total bilirubin level in both groups at the end of treatment. The percent increase in the mean indirect bilirubin level was significantly higher in Group 2 than in Group 1. There was improvement in the Fibrosis-4 (FIB-4) score at the end of treatment in both groups. This improvement was maintained to SVR 12 in both groups. CONCLUSION: Patients with cirrhosis who received SOF, DAC and RBV for 12 weeks had a significantly higher SVR12 rate than those who received SOF and RBV for 24 weeks. In patients who achieved SVR, there was improvement in liver function parameters and the FIB4 score at the time of SVR12 in compared to baseline values.

AIM: This study aimed to evaluate the efficacy and safety of sofosbuvir (SOF)/ribavirin (RBV) and SOF/daclatasvir (DAC)/ RBV in Egyptian patients with hepatitis C virus (HCV)-related cirrhosis and to demonstrate the effects of these treatments on their haematological and biochemical profiles. PATIENTS AND METHODS: A prospective study was performed on 200 patients with HCV-related cirrhosis. Group 1 received SOF and RBV for 24 weeks, and Group 2 received SOF, DAC and RBV for 12 weeks. RESULTS: A sustained virological response (SVR) was achieved in 75 (75%) and 96 (96%) patients in Groups 1 and 2, respectively. The mean haemoglobin (Hb) level and platelet count decreased significantly at the end of treatment in both groups, and the percent decrease was significantly higher in Group 1 than in Group 2. The mean albumin, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels decreased significantly at the end of treatment in both groups. There was a significant increase in the mean total bilirubin level in both groups at the end of treatment. The percent increase in the mean indirect bilirubin level was significantly higher in Group 2 than in Group 1. There was improvement in the Fibrosis-4 (FIB-4) score at the end of treatment in both groups. This improvement was maintained to SVR 12 in both groups. CONCLUSION: Patients with cirrhosis who received SOF, DAC and RBV for 12 weeks had a significantly higher SVR12 rate than those who received SOF and RBV for 24 weeks. In patients who achieved SVR, there was improvement in liver function parameters and the FIB4 score at the time of SVR12 in compared to baseline values.

Background: Hepatitis C virus (HCV) remains a major health problem worldwide with over 170 million persons chronically infected and a burden of 300000 deaths. HCV Genotype 4 is the predominant Genotype in Egypt. During the past decade, a dual combination of pegylated interferon (PegIFN) and ribavirin (RBV) has represented the standard of care. In the era of directly acting antiviral drugs (DAAs), optimal treatment of HCV Genotype 4 remains, more than ever before, to be defined. Simeprevir (SMV) is a second generation NS3/4A protease inhibitor (PI), active against Genotypes 1, 2, 4, 5 and 6. Objectives: To determine the efficacy of Simeprevir-Sofosbuvir for treatment of chronic HCV infection among patients attending Sohag Cardiac and Digestive center (Ministry of Health), Upper Egypt. Patients and Methods: A prospective, hospital based, descriptive study, included 100 patients with chronic HCV infection eligible to receive Simeprevir-Sofosbuvir combination according to the Guidelines of the Ministry of Health. Results: Early virological response (EVR) was achieved in 99%. At the end of treatment, 94% were negative for HCV (ETVR). Finally, 89% of cases were still negative (sustained virological response) (virological response 12 weeks after end of treatment). The total occurrence of side effects among our study population was 13%, and all of them were mild. Conclusion: The combination of SOF and SMV is efficacious and well tolerated and represents a good therapeutic option in patients with chronic HCV in Upper Egypt.