Reviewer's report
Title:Factors Linked to Severe Thrombocytopenia During Antiviral Therapy in
Patients with Chronic Hepatitis C and Pretreatment Low Platelet Counts
Version: 1Date:1 July 2011
Reviewer: Seyed-Moayed Alavian
Reviewer's report:
There are some comments for improvement the manuscript.
1- Thrombocytopenia is one of the extrahepatic manifestations of HCV infection
(Ref: Khattab MA, Eslam M, Alavian SM. Hepatitis C Virus as a Multifaceted
Disease: A Simple and Updated Approach for Extrahepatic Manifestations of
Hepatitis C Virus Infection. Hepat Mon. 2010; 10(4):258-69.) and a variety of
pathogenic mechanisms that are implicated in this abnormal finding are portal
hypertension and hypersplenism in the cirrhosis stage, autoimmune reaction to
platelets, and direct infection of platelet and megakaryocytes by HCV infection.
The authors should differentiate between these mechanisms especially the
existence of cirrhosis or not in their study group. The autoimmune reaction can
exaggerated more the thrombocytopenia.
2- I would lie to understand about the kind of study, retrospective or prospective?
3- It is important to differentiate between the kind of peginterferon,
thrombocytopenia is more common with peg 2a than 2b (Ref: Alavian SM,
Behnava B, Tabatabaei SH. The Comparative Efficacy and Safety of
Peginterferon Alpha-2a vs. 2b for the Treatment of Chronic HCV Infection: A
Meta-Analysis. Hepat Mon. 2010;10(2):121-31.)
4- The authors found that “low albumin (P=0.020), low Hgb level (P=0.026), low
platelet count (P=0.001), genotype non-1 (P=0.033), and rate of platelet decline
at week 2 (P<0.001) were significantly correlated with the development of severe
thrombocytopenia by univariate analysis (Table 2)), I think it means the existence
of cirrhosis before therapy and they should discuss it in the discussion part.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
No Competing interest
Reviewer's report
Title:Factors Linked to Severe Thrombocytopenia During Antiviral Therapy in
Patients with Chronic Hepatitis C and Pretreatment Low Platelet Counts
Version: 1Date:1 July 2011
Reviewer: Seyed-Moayed Alavian
Reviewer's report:
There are some comments for improvement the manuscript.
1- Thrombocytopenia is one of the extrahepatic manifestations of HCV infection
(Ref: Khattab MA, Eslam M, Alavian SM. Hepatitis C Virus as a Multifaceted
Disease: A Simple and Updated Approach for Extrahepatic Manifestations of
Hepatitis C Virus Infection. Hepat Mon. 2010; 10(4):258-69.) and a variety of
pathogenic mechanisms that are implicated in this abnormal finding are portal
hypertension and hypersplenism in the cirrhosis stage, autoimmune reaction to
platelets, and direct infection of platelet and megakaryocytes by HCV infection.
The authors should differentiate between these mechanisms especially the
existence of cirrhosis or not in their study group. The autoimmune reaction can
exaggerated more the thrombocytopenia.
2- I would lie to understand about the kind of study, retrospective or prospective?
3- It is important to differentiate between the kind of peginterferon,
thrombocytopenia is more common with peg 2a than 2b (Ref: Alavian SM,
Behnava B, Tabatabaei SH. The Comparative Efficacy and Safety of
Peginterferon Alpha-2a vs. 2b for the Treatment of Chronic HCV Infection: A
Meta-Analysis. Hepat Mon. 2010;10(2):121-31.)
4- The authors found that “low albumin (P=0.020), low Hgb level (P=0.026), low
platelet count (P=0.001), genotype non-1 (P=0.033), and rate of platelet decline
at week 2 (P<0.001) were significantly correlated with the development of severe
thrombocytopenia by univariate analysis (Table 2)), I think it means the existence
of cirrhosis before therapy and they should discuss it in the discussion part.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
No Competing interest
Please review this paper.
user
Reviewer's report
Title:Factors Linked to Severe Thrombocytopenia During Antiviral Therapy in
Patients with Chronic Hepatitis C and Pretreatment Low Platelet Counts
Version: 1Date:1 July 2011
Reviewer: Seyed-Moayed Alavian
Reviewer's report:
There are some comments for improvement the manuscript.
1- Thrombocytopenia is one of the extrahepatic manifestations of HCV infection
(Ref: Khattab MA, Eslam M, Alavian SM. Hepatitis C Virus as a Multifaceted
Disease: A Simple and Updated Approach for Extrahepatic Manifestations of
Hepatitis C Virus Infection. Hepat Mon. 2010; 10(4):258-69.) and a variety of
pathogenic mechanisms that are implicated in this abnormal finding are portal
hypertension and hypersplenism in the cirrhosis stage, autoimmune reaction to
platelets, and direct infection of platelet and megakaryocytes by HCV infection.
The authors should differentiate between these mechanisms especially the
existence of cirrhosis or not in their study group. The autoimmune reaction can
exaggerated more the thrombocytopenia.
2- I would lie to understand about the kind of study, retrospective or prospective?
3- It is important to differentiate between the kind of peginterferon,
thrombocytopenia is more common with peg 2a than 2b (Ref: Alavian SM,
Behnava B, Tabatabaei SH. The Comparative Efficacy and Safety of
Peginterferon Alpha-2a vs. 2b for the Treatment of Chronic HCV Infection: A
Meta-Analysis. Hepat Mon. 2010;10(2):121-31.)
4- The authors found that “low albumin (P=0.020), low Hgb level (P=0.026), low
platelet count (P=0.001), genotype non-1 (P=0.033), and rate of platelet decline
at week 2 (P<0.001) were significantly correlated with the development of severe
thrombocytopenia by univariate analysis (Table 2)), I think it means the existence
of cirrhosis before therapy and they should discuss it in the discussion part.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
No Competing interest
assistant