Danish human rights activist Abdulhadi al-Khawaja is among 13 activists who have exhausted all their opportunities for release after their convictions were upheld by the Bahraini appeals court on Monday.

The activists were among 20 who were sentenced for their roles in the 2011 anti-government protests that called for increased human rights and greater freedoms for the Shia Muslim majority.

The government, run by the Sunni Muslim royal family, responded to the protests by initiating a brutal clampdown with the help of troops from neighbouring Sunni states.

Al-Khawaja and seven others were given life sentences after being convicted of plotting to overthrow the state − sentences that remain in place despite strong international pressure on the Bahraini government.

Al-Khawaja's 110-day hunger strike, that ended last May, also proved ineffective in securing his release.

According to the BBC, the men’s lawyers said it was their last chance to have their sentences overturned or reduced.

Stinne Lyager Bech from Amnesty International told state broadcaster DR that while the court’s decision was expected, it was still disappointing.

“It’s a shame and a scandal that his sentence has once again been upheld by the Bahrain court,” Lysager said. "He shouldn’t be sitting in jail; he’s done nothing more than peacefully fight for democracy and human rights.”

Lysager added that the international community should continue to place pressure on the Bahraini government in order to secure the release of the human rights activists. A pardon by the Bahraini king remains the last option for the activists.

The foreign minister, Villy Søvndal, said in a press release that he was also disappointed by the appeal court’s verdict and that Denmark would continue to support the plight of al-Khawaja and the other jailed human rights activists.

“It’s important to highlight that we are talking about a Danish citizen who has been sentenced for speaking out in his struggle for human rights, and who has also been tortured,” Søvndal wrote. “Abulhadi al-Khawaja’s continued work promoting democracy and respect for human rights is widely known. Together with the countries that support Denmark’s position, including the EU and the UN, we will examine further options that could lead to the release of al-Khawaja and the other human rights and democracy advocates in Bahrain.”

Dozens have died and around 3,000 people have been arrested by Bahraini authorities due to the uprising, including doctors who were punished for treating injured protesters.

Al-Khawaja fled to Denmark in the 1980s and was awarded political asylum because of the persecution he faced in Bahrain for his human rights work. He took on Danish citizenship in the 1990s and returned to Bahrain to continue his work in the early 2000s following some political reform in the country.

In October, he was awarded the Freedom Prize by Politiken newspaper in recognition of his work in the region.