Generic and brand DAAs are equally effective for achieving SVR and improving aminotransferases.

Only a few treatments are approved for coronavirus disease‐2019 (COVID‐19) infections, with continuous debate about their clinical impact. Repurposing antiviral treatments might prove the fastest way to identify effective therapy. This trial aimed to evaluate the efficacy and safety of sofosbuvir (SOF) plus daclatasvir (DCV) or ravidasvir (RDV) added to standard care (SOC) for patients with moderate and severe COVID‐19 infection. Multicentre parallel randomized controlled open‐label trial. One hundred and twenty eligible patients with moderate and severe COVID‐19 infection were randomized to one of the study arms. Ten days of treatment with SOF plus DCV or RDV in addition to the standard of care compared to SOC. Follow up in 7 days. Sum of the counted symptoms at 7 and 10 days, mean change in oxygen saturation level, viral negativity, and rate of intensive care unit (ICU) admission. Compared to SOC, the SOF‐DCV group experienced a significantly lower sum of the counted symptoms (fever, headache, generalized aches, or respiratory distress) combined with no evidence of deterioration (ICU admission and mechanical ventilation) on Days 7 and 10 of treatment. Oxygen saturation also significantly improved among the SOF‐DCV group compared to SOC starting from Day 4. The study also showed positive trends regarding the efficacy of SOF‐DCV with a lower incidence of mortality. On the other hand, adding SOF‐RDV to SOC did not show significant improvements in endpoints. The results support the efficacy and safety of SOF‐DCV as an add‐on to SOC for the treatment of moderate to severe COVID‐19 infections.

Background Post-variceal band ligation bleeding ulcer is a severe complication with considerable mortality. We tried evaluating self-expandable metallic stent (SEMS) with concern to the ulcer morphology not well studied. Results We did a retrospective analysis of patients with bleeding post-band ulcers and treated by SEMS with concern to control bleeding and 6 weeks survival. Twenty-eight patients studied had their age (mean ± S.D.) 57.8 ± 8.6 years, and 85.7% were males. The Child-Pugh score range was 5–12]. Control of bleeding by SEMS was achieved in 23 (82.1%) patients, and overall, 6-week survival was 75%. Both post-band ulcer types B (oozing blood and type C (active spurted) were a risk for 6 weeks mortality (P = 0.04, OR 1.58, CI 95% 1.12–2.23). Conclusion SEMS is considered an excellent choice to control esophageal post-banding ulcer bleeding and a definite treatment bridge.

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Aim: Hepatic resection (HR) in cirrhotic patients with hepatocellular carcinoma (HCC) and portal hypertension (PHT) is not recommended, according to international guidelines. The aim of the present study was to determine the outcome of HR for HCC in cirrhotic patients with PHT. Methods: The present study was a single institutional, retrospective study of 170 Child-Pugh class A cirrhotic patients who underwent HR for HCC from 2011 to July 2015. The patients were divided into two groups, according to the presence and absence of PHT. Results: PHT was present in 91 patients (53.5 per cent). The postoperative morbidity was insignificantly higher in patients with PHT than patients without PHT (31.9 per cent vs 25.3 per cent, respectively, P = 0.36). Patients with PHT showed 90-day perioperative mortality (3.3 per cent), which was similar to patients without PHT (2.5 per cent). In the subgroup analysis, the 1-, 3-and 5-year overall survival for patients with limited HR was 90.3 per cent, 74.3 per cent and 66.2 per cent, respectively, for patients with PHT, and 93.9 per cent, 80.9 per cent and 73.6 per cent, respectively, for patients without PHT, without a significant statistical difference (P = 0.38). Conclusion: HR in Child-Pugh class A cirrhotic patients with PHT is a safe and effective procedure with good short-and long-term outcomes in comparison to patients without PHT, especially those with limited liver resection.