Gamal Esmat

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Gamal Esmat
Gamal Esmat Profile.jpg
Born
Gamal Eldin Esmat Gamil

3 January 1956 (1956-01-03) (age 66)
Giza, Egypt
NationalityEgyptian
Education Cairo University
Years active1981 - now
Known forPrevention, screening and treatment of viral hepatitis; Hepatocellular carcinoma and living related liver transplantation
Medical career
FieldMedicine
InstitutionsKasr El Aini School of Medicine, Cairo University
Sub-specialtiesHepatology
ResearchViral Hepatitis, Hepatocellular Carcinoma and Liver Transplantation
Website http://www.gamalesmat.com/

Gamal Esmat is a professor at Endemic Medicine and Hepatogastroenterology Department, Cairo University. He was vice president of Cairo University for Graduate Studies and Research.

Contents

Esmat has published scientific papers in journals on hepatitis, hepatocellular carcinoma and liver transplantation. Since 2001, he is the director of Clinical Research Unit, Hepatitis C Project, International Health Division, University of Maryland, Baltimore.

Esmat was the president of IASL (International Association for the Study of the Liver) during the period 2006 – 2008 and is recently the WHO consultant for management of viral hepatitis. [1]

Early life and career

Esmat was born on 3 January 1956 in Giza, Egypt.

Esmat is professor of Endemic Hepatology and Gastroenterology at Kasr El Ainy Hospital, Faculty of Medicine, Cairo University, Egypt.He specialized in viral hepatitis and its sequelae, as well as related and advanced techniques such as abdominal ultrasonography and different endoscopic modalities.

Research and achievements

Esmat has worked in epidemiology, treatment and prevention of viral hepatitis, also enabling individualization of its treatment. He later developed further treatment strategies using the first Egyptian developed HCV Direct Antiviral Agent (DAA) for the hard-to-treat, interferon experienced and cirrhotic patients, revolutionizing HCV treatment.

Schistosomiasis research

Esmat's researches started in 1985 through the Schistosomiasis Research Project. He was the co-PI, studying the epidemiology and prevalence of schistosomiasis in 12 Egyptian governorates. In this project, Esmat mastered abdominal ultrasonography for the first time in diagnosis and grading of hepatic schistosomiasis which was approved by the WHO as an ideal method for the diagnosis of schistosomiasis. This project had great impact in the control of schistosomiasis in Egypt that led to the decrease of prevalence from 40% in the 1980s to 2% in the 2000s.

Esmat contributed to the first textbook "Clinical application of 3D ultrasonography", by a chapter titled "Three dimensional ultrasonography in hepatogastroenterology". In addition, he also contributed in the hepatology text book "Zakim and Boyer's Hepatology", by a chapter titled "Parasitic liver disease".

National Committee for Control of Viral Hepatitis

Esmat established the Hepatology Clinical Trials Research Unit (HCTRU) in the National Hepatology and Tropical Medicine Research Institute (NHTMRI) in the Egyptian Ministry of Health in collaboration with the department of epidemiology and preventive medicine at University of Maryland School of Medicine in Baltimore, USA.

In this centre, many clinical trials were conducted and about 800 Egyptian patients were treated for free and the first trial to evaluate the efficacy of pegylated interferon for treatment of HCV genotype 4. In 2009, Esmat established the Kasr el Ainy viral hepatitis treatment center in Cairo University. This is areferral centre for Egyptian patients for prevention, diagnosis and treatment of chronic HCV. Esmat's work helped a national guidelines strategy in Egypt for the management of HCV, HBV and hepatocellular carcinoma. [2]

Recent achievements

In 2013, when the directly acting antiviral agents developed, Esmat established different clinical trials in HCV genotype 4, then due to his research in this field, he succeeded, together with the national committee members, to introduce all the new drugs for treatment of viral hepatitis C genotype 4 with a very affordable price.

Esmat developed a system for recruitment of patients and database processing. This enabled a successful mass treatment of up to 150,000 Egyptian patients per year, by introducing the sofosbuvir based regimens. The plan was to treat 300.000 patients by the all oral antiviral therapy in the following years.

Esmat succeeded in the offering of variable DAAs (as sofosbuvir, simeprevir, daclatasvir, ombitasvir and paritaprevir, ledipasvir) in Egypt at affordable prices. Esmat's aim was to eradicate HCV in Egypt in the upcoming 20 years. His work was rated by the WHO as one of the most important strategies arising from research they have supported.

In late 2015, Esmat announced the results of a large clinical trial on an Egyptian molecule by Pharco. It was the first milestone in addressing the hepatitis C epidemic in EGYPT. This is a Phase III clinical trial of the combination of Ravidasvir with Sofosbuvir for the treatment of patients with Genotype-4 chronic hepatitis C virus, the largest study of its kind globally.

The lead Principal Investigator of the study, Esmat announced it at the meeting of the American Association for the Study of Liver Diseases conference in San Francisco on November 16, 2015. Results from the Phase III trial in 300 patients showed that combining Ravidasvir 200 mg and Sofosbuvir 400 mg once daily for 12 weeks resulted in sustained virological response at 12 week post-treatment rates of 98% overall. The study indicated the possibility of treating compensated cirrhotic patients with a high response rate when extending therapy to 16 weeks. No relapses have occurred to date in difficult to treat Interferon-experienced cirrhotic patients treated for 16 weeks. [3]

Honours and awards

[4]

Related Research Articles

<span class="mw-page-title-main">Hepatitis</span> Inflammation of the liver

Hepatitis is inflammation of the liver tissue. Some people or animals with hepatitis have no symptoms, whereas others develop yellow discoloration of the skin and whites of the eyes (jaundice), poor appetite, vomiting, tiredness, abdominal pain, and diarrhea. Hepatitis is acute if it resolves within six months, and chronic if it lasts longer than six months. Acute hepatitis can resolve on its own, progress to chronic hepatitis, or (rarely) result in acute liver failure. Chronic hepatitis may progress to scarring of the liver (cirrhosis), liver failure, and liver cancer.

<span class="mw-page-title-main">Hepatitis C</span> Human viral infection

Hepatitis C is an infectious disease caused by the hepatitis C virus (HCV) that primarily affects the liver; it is a type of viral hepatitis. During the initial infection people often have mild or no symptoms. Occasionally a fever, dark urine, abdominal pain, and yellow tinged skin occurs. The virus persists in the liver in about 75% to 85% of those initially infected. Early on, chronic infection typically has no symptoms. Over many years however, it often leads to liver disease and occasionally cirrhosis. In some cases, those with cirrhosis will develop serious complications such as liver failure, liver cancer, or dilated blood vessels in the esophagus and stomach.

Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) co-infection is a multi-faceted, chronic condition that significantly impacts public health. According to the World Health Organization (WHO), 2 to 15% of those infected with HIV are also affected by HCV, increasing their risk of morbidity and mortality due to accelerated liver disease. The burden of co-infection is especially high in certain high-risk groups, such as intravenous drug users and men who have sex with men. These individuals who are HIV-positive are commonly co-infected with HCV due to shared routes of transmission including, but not limited to, exposure to HIV-positive blood, sexual intercourse, and passage of the Hepatitis C virus from mother to infant during childbirth.

<span class="mw-page-title-main">Boceprevir</span>

Boceprevir is a protease inhibitor used to treat hepatitis caused by hepatitis C virus (HCV) genotype 1. It binds to the HCV nonstructural protein 3 active site.

<span class="mw-page-title-main">Telaprevir</span>

Telaprevir (VX-950), marketed under the brand names Incivek and Incivo, is a pharmaceutical drug for the treatment of hepatitis C co-developed by Vertex Pharmaceuticals and Johnson & Johnson. It is a member of a class of antiviral drugs known as protease inhibitors. Specifically, telaprevir inhibits the hepatitis C viral enzyme NS3/4A serine protease. Telaprevir is only indicated for use against hepatitis C genotype 1 viral infections and has not been proven to be safe or effective when used for other genotypes of the virus. The standard therapy of pegylated interferon and ribavirin is less effective than telaprevir in those with genotype 1.

A hepatitis C vaccine, a vaccine capable of protecting against the hepatitis C virus (HCV), is not yet available. Although vaccines exist for hepatitis A and hepatitis B, development of an HCV vaccine has presented challenges. No vaccine is currently available, but several vaccines are currently under development.

<span class="mw-page-title-main">Sofosbuvir</span>

Sofosbuvir, sold under the brand name Sovaldi among others, is a medication used to treat hepatitis C. It is taken by mouth.

<span class="mw-page-title-main">Daclatasvir</span> Chemical compound

Daclatasvir, sold under the brand name Daklinza, is an antiviral medication used in combination with other medications to treat hepatitis C (HCV). The other medications used in combination include sofosbuvir, ribavirin, and interferon, vary depending on the virus type and whether the person has cirrhosis. It is taken by mouth.

<span class="mw-page-title-main">Simeprevir</span> Chemical compound

Simeprevir, sold under the trade names Olysio among others, is a medication used in combination with other medications for the treatment of hepatitis C. It is specifically used for hepatitis C genotype 1 and 4. Medications it is used with include sofosbuvir or ribavirin and peginterferon-alfa. Cure rates are in 80s to 90s percent. It may be used in those who also have HIV/AIDS. It is taken by mouth once daily for typically 12 weeks.

<span class="mw-page-title-main">Ledipasvir</span> Hepatitis C drug

Ledipasvir is a drug for the treatment of hepatitis C that was developed by Gilead Sciences. After completing Phase III clinical trials, on February 10, 2014, Gilead filed for U.S. approval of a ledipasvir/sofosbuvir fixed-dose combination tablet for genotype 1 hepatitis C. The ledipasvir/sofosbuvir combination is a direct-acting antiviral agent that interferes with HCV replication and can be used to treat patients with genotypes 1a or 1b without PEG-interferon or ribavirin.

<span class="mw-page-title-main">Ledipasvir/sofosbuvir</span> Medication used to treat hepatitis C

Ledipasvir/sofosbuvir, sold under the trade name Harvoni among others, is a medication used to treat hepatitis C. It is a fixed-dose combination of ledipasvir and sofosbuvir. Cure rates are 94% to 99% in people infected with hepatitis C virus (HCV) genotype 1. Some evidence also supports use in HCV genotype 3 and 4. It is taken daily by mouth for 8–24 weeks.

Ombitasvir/paritaprevir/ritonavir, sold under the brand name Technivie among others, is a medication used to treat hepatitis C. It is a fixed-dose combination of ombitasvir, paritaprevir, and ritonavir. Specifically it is used together with dasabuvir or ribavirin for cases caused by hepatitis C virus genotype 1 or 4. Cure rates are around 95%. It is taken by mouth.

<span class="mw-page-title-main">Beclabuvir</span>

Beclabuvir is an antiviral drug for the treatment of hepatitis C virus (HCV) infection that has been studied in clinical trials. In February 2017, Bristol-Myers Squibb began sponsoring a post-marketing trial of beclabuvir, in combination with asunaprevir and daclatasvir, to study the combination's safety profile with regard to liver function. From February 2014 to November 2016, a phase II clinical trial was conducted on the combination of asunaprevir/daclatasvir/beclabuvir on patients infected with both HIV and HCV. Furthermore, a recent meta-analysis of six published six clinical trials showed high response rates in HCV genotype 1-infected patients treated with daclatasvir, asunaprevir, and beclabuvir irrespective of ribavirin use, prior interferon-based therapy, or restriction on noncirrhotic patients, IL28B genotype, or baseline resistance-associated variants

Elbasvir/grazoprevir is a fixed-dose combination for the treatment of hepatitis C, containing elbasvir and grazoprevir. It is used to treat chronic hepatitis C virus (HCV) genotypes 1 or 4 infection in both treatment-naïve and treatment-experienced patients.

<span class="mw-page-title-main">Sofosbuvir/daclatasvir</span>

Daclatasvir/sofosbuvir is a two-drug combination for the treatment of hepatitis C. It is given as a single daily pill containing daclatasvir, a viral NS5A inhibitor, and sofosbuvir, a nucleotide inhibitor of the viral RNA polymerase NS5B.

<span class="mw-page-title-main">Narlaprevir</span>

Narlaprevir, is an inhibitor of NS3/4A serine protease, intended for the treatment of chronic hepatitis C caused by genotype 1 virus in combination with other antiviral drugs.

Sofosbuvir/velpatasvir, sold under the brand name Epclusa among others, is a fixed-dose combination medication for the treatment of hepatitis C in adults. It combines sofosbuvir and velpatasvir. It is more than 90% effective for hepatitis C genotypes one through six. It also works for hepatitis C in those who also have cirrhosis or HIV/AIDS. It is taken by mouth.

Glecaprevir/pibrentasvir (G/P), sold under the brand names Mavyret and Maviret, is a fixed-dose combination medication used to treat hepatitis C. It contains glecaprevir and pibrentasvir. It works against all six types of hepatitis C. At twelve weeks following treatment between 81% and 100% of people have no evidence of hepatitis C. It is taken once a day by mouth with food.

<span class="mw-page-title-main">NS5B inhibitor</span>

Non-structural protein 5B (NS5B) inhibitors are a class of direct-acting antivirals widely used in the treatment of chronic hepatitis C. Depending on site of action and chemical composition, NS5B inhibitors may be categorized into three classes—nucleoside active site inhibitors (NIs), non-nucleoside allosteric inhibitors, and pyrophosphate analogues. Subsequently, all three classes are then subclassified. All inhibit RNA synthesis by NS5B but at different stages/sites resulting in inability of viral RNA replication. Expression of direct-acting NS5B inhibitors does not takes place cells that are not infected by hepatitis C virus, which seems to be beneficial for this class of drugs.

<span class="mw-page-title-main">Interferon Lambda 4</span> Protein-coding gene in the species Homo sapiens

Interferon lambda 4 is one of the most recently discovered human genes and the newest addition to the interferon lambda protein family. This gene encodes the IFNL4 protein, which is involved in immune response to viral infection.

References

  1. ↑ "Gamal Esmat". www.journals.elsevier.com. Retrieved 2018-09-17.
  2. ↑ McNeil, Donald G. Jr. "Curing Hepatitis C, in an Experiment the Size of Egypt" . Retrieved 2018-09-17.
  3. ↑ "Pharco Pharmaceuticals Inc. Reports Ravidasvir Achieved 100% Cure Rate to Date When Combined with Sofosbuvir for HCV, Non-Cirrhotic, Genotype 4 Patients" . Retrieved 2018-09-17.
  4. ↑ "Prof. Gamal Esmat". www.gamalesmat.com. Retrieved 2018-09-17.
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