Reviewer ’s report  
 
Title: Impact of Antiviral Therapy on Hepatocellular Carcinoma and Mortality in Patients with 
Chronic Hepatitis C: Systematic Review and Meta -analysis  
 
Version: 0 Date: 30 Jan 2017  
 
Reviewer: Claudio Luchini  
 
Reviewer's report:  
 
Global evaluation:  
I have read with great interest this paper. The Methods of this meta -analysis have been 
conducted in a good way. The message is quite clear (although the paper seems too long in some 
parts in my opinion, see below). The findings are relevant. The discussion is quite complete (see 
below). The English language is excellent. I suggest to address these suggestions, then this paper 
merits publicati on in my opinion, a long work, as well as good.  
 
Major comments/requested revision:  
1. I suggest to summarize some parts (>4000 words is too long), above all in the Results - 
section of characteristics of the included study….a total of 25 studies…a total o f 17 
studies…a total of 13 studies…2 pages and a half is too long! Please summarize with a table 
or something similar, here you can put only a paragraph summarizing all these 2 pages and a 
half. This is very important since the goal is to have a standardiz ed method and clear results, 
but not in a very dispersive way. Thanks.  
 
2. In the discussion section please put a paragraph on the importance of country, for example, 
present please summarized data about your results by country (East countries, American, 
European….). We know that the clinical but also the molecular pathways to HCC can follow 
different ways on the basis of countries. Although this study is focused on HCV, many other 
co-morbidities or the diet (fat, alcohol,…) can promote HCC carcinogenesis wi th the virus, 
so please discuss some implications on this topic. This is very important for many potential 
readers of this journal.  
 
Minor or editorial points:  
1. Please explain also in the abstract the acronym SVR (sustained virologic response) when 
used at the first time. Thanks.  
 
Are the methods appropriate and well described?  
If not, please specify what is r equired in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects req uire further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of  competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, eithe r now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents r elating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing inter ests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare th at I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand t hat any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Impact of Antiviral Therapy on Hepatocellular Carcinoma and Mortality in Patients with 
Chronic Hepatitis C: Systematic Review and Meta -analysis  
 
Version: 0 Date: 30 Jan 2017  
 
Reviewer: Claudio Luchini  
 
Reviewer's report:  
 
Global evaluation:  
I have read with great interest this paper. The Methods of this meta -analysis have been 
conducted in a good way. The message is quite clear (although the paper seems too long in some 
parts in my opinion, see below). The findings are relevant. The discussion is quite complete (see 
below). The English language is excellent. I suggest to address these suggestions, then this paper 
merits publicati on in my opinion, a long work, as well as good.  
 
Major comments/requested revision:  
1. I suggest to summarize some parts (>4000 words is too long), above all in the Results - 
section of characteristics of the included study….a total of 25 studies…a total o f 17 
studies…a total of 13 studies…2 pages and a half is too long! Please summarize with a table 
or something similar, here you can put only a paragraph summarizing all these 2 pages and a 
half. This is very important since the goal is to have a standardiz ed method and clear results, 
but not in a very dispersive way. Thanks.  
 
2. In the discussion section please put a paragraph on the importance of country, for example, 
present please summarized data about your results by country (East countries, American, 
European….). We know that the clinical but also the molecular pathways to HCC can follow 
different ways on the basis of countries. Although this study is focused on HCV, many other 
co-morbidities or the diet (fat, alcohol,…) can promote HCC carcinogenesis wi th the virus, 
so please discuss some implications on this topic. This is very important for many potential 
readers of this journal.  
 
Minor or editorial points:  
1. Please explain also in the abstract the acronym SVR (sustained virologic response) when 
used at the first time. Thanks.  
 
Are the methods appropriate and well described?  
If not, please specify what is r equired in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects req uire further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of  competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, eithe r now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents r elating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing inter ests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare th at I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand t hat any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Impact of Antiviral Therapy on Hepatocellular Carcinoma and Mortality in Patients with 
Chronic Hepatitis C: Systematic Review and Meta -analysis  
 
Version: 0 Date: 30 Jan 2017  
 
Reviewer: Claudio Luchini  
 
Reviewer's report:  
 
Global evaluation:  
I have read with great interest this paper. The Methods of this meta -analysis have been 
conducted in a good way. The message is quite clear (although the paper seems too long in some 
parts in my opinion, see below). The findings are relevant. The discussion is quite complete (see 
below). The English language is excellent. I suggest to address these suggestions, then this paper 
merits publicati on in my opinion, a long work, as well as good.  
 
Major comments/requested revision:  
1. I suggest to summarize some parts (>4000 words is too long), above all in the Results - 
section of characteristics of the included study….a total of 25 studies…a total o f 17 
studies…a total of 13 studies…2 pages and a half is too long! Please summarize with a table 
or something similar, here you can put only a paragraph summarizing all these 2 pages and a 
half. This is very important since the goal is to have a standardiz ed method and clear results, 
but not in a very dispersive way. Thanks.  
 
2. In the discussion section please put a paragraph on the importance of country, for example, 
present please summarized data about your results by country (East countries, American, 
European….). We know that the clinical but also the molecular pathways to HCC can follow 
different ways on the basis of countries. Although this study is focused on HCV, many other 
co-morbidities or the diet (fat, alcohol,…) can promote HCC carcinogenesis wi th the virus, 
so please discuss some implications on this topic. This is very important for many potential 
readers of this journal.  
 
Minor or editorial points:  
1. Please explain also in the abstract the acronym SVR (sustained virologic response) when 
used at the first time. Thanks.  
 
Are the methods appropriate and well described?  
If not, please specify what is r equired in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects req uire further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of  competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, eithe r now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents r elating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing inter ests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare th at I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand t hat any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant