Mohamed Soltan, a 27-year-old dual US-Egyptian citizen, was not in court when Judge Mohamed Nagi Shehata sentenced him to life imprisonment this past weekend.

He has been on a hunger strike for more than a year to protest his jailing by Egyptian authorities, days after security forces in August 2013 broke up the Rabaa protest camp. Participants were demonstrating against the military coup that took place one month prior, in which hundreds of protesters were killed and Soltan himself was shot in the arm.

Since then, sweeping arrests by security forces and prosecutions by Egypt’s judiciary have affected as many as 42,000 people, according to some watchdog groups. Dozens of others were given life sentences in Cairo on Saturday, while 14 members of the Muslim Brotherhood, including leader Mohamed Badie and Soltan’s father Salah, were sentenced to die.

“Our family is both horrified and deeply saddened by the sentence,” Hanaa Soltan, Mohamed’s sister, tweeted from her home in the United States. Noting that she and her family had “always placed absolutely zero faith in the ability of a deeply politicised Egyptian judiciary to consider Mohamed’s case fairly”, Hanaa reiterated calls for the US government to facilitate a humanitarian release for her brother, whose hunger strike has caused “irreparable damage to his body,” according to American diplomats working on his case.

Calls for the US to step in on Soltan’s behalf have not gone totally unanswered. Both President Barack Obama and Secretary of State John Kerry called for his unconditional release on humanitarian grounds after he began his hunger strike.

“The case had a low profile until he started his hunger strike, with the Egyptians reluctant to even admit he was being held,” said Waleed Nassar, a senior associate with Lewis Baach PLLC, the law firm representing Soltan in the US. This led to “an uphill battle where you have to prove your client exists”, Nassar told Al Jazeera.

“Some [American] congressmen told us the Egyptian ambassador denied that Egypt was holding Soltan in prison on at least two occasions,” said Nassar, who specialises in international dispute resolution.

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