Working towards a personalized cure for Hepatitis C

The Hepatitis C virus represents a major global public health problem and Egypt has the highest prevalence of the disease in the world. For World Hepatitis Day, DiscovHER interviewed Dr. Nourtan Abdeltawab, an Egyptian scientist whose ultimate goal is to create a genetic test that will determine which Hepatitis C medicine is right for any given patient, rather than the trial and error approach that is, for the moment, the only choice available to doctors.

What is the situation of Hepatitis treatments in Egypt and the world?

The focus on hepatitis C (HCV) diseases has led to development of multiple novel direct acting antiviral drugs (DAA). These DAAs have been used to treat hepatitis C viral infections all over the world. Each group of DAA is specific to a certain HCV genotype. In Egypt, HCV genotype 4 is the most prevalent.

There are several recommendations for treatment of HCV genotype 4. Drug recommendations include FDA approved Sovaldi (sofosbuvir) with ribavirin, Sovaldi with ribavirin and PEG interferon, Olysio (simeprevir) with Sovaldi with or without ribavirin. Other recommendations include Harvoni (ledipasvir with sofosbuvir), or ombitasvir / paritaprevir / ritonavir with ribavirin. In Egypt we have patients on Sovaldi and ribavirin with or without interferon. Olysio is supposed to be released to Egyptian hospitals within few weeks. Other drugs are under studies for use in the Egyptian population.

How is your research helping cure the disease?

My research focuses on studying the differential response of Egyptian patients to the new therapies for hepatitis C. There are noted variations in patients’ response to the previous therapy in Egypt (PEG interferon and ribavirin). Patients’ genes modulate this differential response. Studying patients’ genes to predict their response to drugs is known as pharmacogenetics. Meaning we study the patients’ genes, which make every person have a unique response to the drug. After we get the results we might be able to design a diagnostic genetic test for the patient before taking the treatment. Based on the genetic test we will be able to predict if the treatment is suitable for the patient or not, thus enabling us to personalize treatment for HCV patients. This is a much-needed approach which saves time, money, and offers better treatment choices for the patient.

What made you choose your research subject?

My doctoral studies in the United States focused on applying systems biology to understanding why patients respond differently to the same disease. After I returned to Egypt, I wanted to apply my training to try to face an important health issue in my country. Hepatitis C viral infections (HCV) are prevalent in Egypt, with patients having different responses to therapy. I chose to study the pharmacogenetics of HCV, as I hope that through my research I will be able to develop a diagnostic test that can predict patient response to HCV therapy, improving their treatment.


How do you manage to balance your family life and your work?

I do not. Family life and work are both parts of my life. Sometimes the balance drifts towards one or the other. It is like juggling spinning plates. Sometimes you are able to keep all plates spinning and everyone is happy for a minute. The next minute one of the plates falls. At that point, one should not stop, one keeps on juggling otherwise all plates will fall. Of course, from time to time one has to get a break from it all.

Is science perceived as masculine or gender neutral in Egypt?

This is a rather difficult question to answer, especially since I have been away from Egypt for 8 years and came back 3 years ago. From my “new” observations, I would say, number wise, the numbers of female scientists in Egypt are almost equal to male scientists. This number equality is represented from young masters and PhD students to head of departments. Yet numbers do not remain the same if you look at higher administrative positions. Although numbers are almost equal, I do not think we have reached gender neutrality in Egypt. There is always a subtle discrimination against female scientists. This is especially true because of the patriarchal society. Even women are not true believers of themselves or fellow women scientists. You would see some young TAs far more fascinated with male scientists than equally established female scientists. The entire society, not just the scientific one has to grow and change.

Dr. Nourtan Abdeltawab is an Assistant Professor at the Department of Microbiology and Immunology, in the Faculty of Pharmacy at Cairo University. She won a L’Oréal-UNESCO International Rising Talent Award in 2015. Follow her on Twitter at @nourtan.

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