Reviewer's report
Title:Association of genetic variations in GNB1 with response to peginterferon
plus ribavirin therapy for chronic hepatitis C in a Chinese population in Taiwan
Version: 1Date:27 August 2012
Reviewer: Claudio Puoti
Reviewer's report:
This is an interesting paper aimed at evaluating whether polymorphisms in the
GNB1 gene are associated with a RVR among HCV-1 and HCV-2 infected
patients receiving peginterferon plus ribavirin treatment (PEG-IFN -RBV). The
main conclusion of this study is that GNB1 polymorphisms might be associated
with the therapeutic outcomes of HCV-1 and HCV-2 infected patients under
standard of care treatment.
This issue is interesting and rather innovative, as the authors did evaluate the
association between single nucleotide polymorphisms (SNPs) in the GNB1 gene
and their susceptibility to RVR in Chinese patients in Taiwan receiving PEG-IFN
-RBV treatment.
The paper is well written and the patient series is huge (265 HCV-1 infected
patients and 195 HCV-2 infected patients), so I have only few comments.
MAJOR COMMENTS
1. The main pitfall of this study is that no information about liver histology or liver
fibrosis by non-invasive methods is given. The lack of these data strongly
decrease the strength of the work. In other words, the higher response rate found
among some HCV-1 and HCV-2 patients might theoretically be due to a lower
fibrosis degree in these sub-groups rather than to GNB1 polymorphisms.
2. How many flat responders were seen among non-RVR patients, and did they
differ according to GNB1 polymorphisms?
3. Recent guidelines (for example, see EASL Clinical Practice Guidelines:
Management of hepatitis C
virus infection, J Hepatol 2011) suggest that patients with HCV genotypes 1
should receive a weight-based dose of ribavirin of 15 mg/kg body weight per day.
In this study, patients > 80 kg received a maximum RBV dose of 1000 mg/day,
that might justify the absence of RVR in some HCV-1 patients.
MINOR COMMENTS
1. Further data on patient features should be added in table 1 (ALT levels, PLT
count, etc)
2. Were IL28b polymorphisms available in this series of patients ? is so, I
strongly suggest to add these results.
3. the authors should specify that patients were treated with PEG IFN alfa 2b.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
CLAUDIO PUOTI, MD
LIVER UNIT, MARINO, ROMA, ITALY
Reviewer's report
Title:Association of genetic variations in GNB1 with response to peginterferon
plus ribavirin therapy for chronic hepatitis C in a Chinese population in Taiwan
Version: 1Date:27 August 2012
Reviewer: Claudio Puoti
Reviewer's report:
This is an interesting paper aimed at evaluating whether polymorphisms in the
GNB1 gene are associated with a RVR among HCV-1 and HCV-2 infected
patients receiving peginterferon plus ribavirin treatment (PEG-IFN -RBV). The
main conclusion of this study is that GNB1 polymorphisms might be associated
with the therapeutic outcomes of HCV-1 and HCV-2 infected patients under
standard of care treatment.
This issue is interesting and rather innovative, as the authors did evaluate the
association between single nucleotide polymorphisms (SNPs) in the GNB1 gene
and their susceptibility to RVR in Chinese patients in Taiwan receiving PEG-IFN
-RBV treatment.
The paper is well written and the patient series is huge (265 HCV-1 infected
patients and 195 HCV-2 infected patients), so I have only few comments.
MAJOR COMMENTS
1. The main pitfall of this study is that no information about liver histology or liver
fibrosis by non-invasive methods is given. The lack of these data strongly
decrease the strength of the work. In other words, the higher response rate found
among some HCV-1 and HCV-2 patients might theoretically be due to a lower
fibrosis degree in these sub-groups rather than to GNB1 polymorphisms.
2. How many flat responders were seen among non-RVR patients, and did they
differ according to GNB1 polymorphisms?
3. Recent guidelines (for example, see EASL Clinical Practice Guidelines:
Management of hepatitis C
virus infection, J Hepatol 2011) suggest that patients with HCV genotypes 1
should receive a weight-based dose of ribavirin of 15 mg/kg body weight per day.
In this study, patients > 80 kg received a maximum RBV dose of 1000 mg/day,
that might justify the absence of RVR in some HCV-1 patients.
MINOR COMMENTS
1. Further data on patient features should be added in table 1 (ALT levels, PLT
count, etc)
2. Were IL28b polymorphisms available in this series of patients ? is so, I
strongly suggest to add these results.
3. the authors should specify that patients were treated with PEG IFN alfa 2b.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
CLAUDIO PUOTI, MD
LIVER UNIT, MARINO, ROMA, ITALY
Please review this paper.
user
Reviewer's report
Title:Association of genetic variations in GNB1 with response to peginterferon
plus ribavirin therapy for chronic hepatitis C in a Chinese population in Taiwan
Version: 1Date:27 August 2012
Reviewer: Claudio Puoti
Reviewer's report:
This is an interesting paper aimed at evaluating whether polymorphisms in the
GNB1 gene are associated with a RVR among HCV-1 and HCV-2 infected
patients receiving peginterferon plus ribavirin treatment (PEG-IFN -RBV). The
main conclusion of this study is that GNB1 polymorphisms might be associated
with the therapeutic outcomes of HCV-1 and HCV-2 infected patients under
standard of care treatment.
This issue is interesting and rather innovative, as the authors did evaluate the
association between single nucleotide polymorphisms (SNPs) in the GNB1 gene
and their susceptibility to RVR in Chinese patients in Taiwan receiving PEG-IFN
-RBV treatment.
The paper is well written and the patient series is huge (265 HCV-1 infected
patients and 195 HCV-2 infected patients), so I have only few comments.
MAJOR COMMENTS
1. The main pitfall of this study is that no information about liver histology or liver
fibrosis by non-invasive methods is given. The lack of these data strongly
decrease the strength of the work. In other words, the higher response rate found
among some HCV-1 and HCV-2 patients might theoretically be due to a lower
fibrosis degree in these sub-groups rather than to GNB1 polymorphisms.
2. How many flat responders were seen among non-RVR patients, and did they
differ according to GNB1 polymorphisms?
3. Recent guidelines (for example, see EASL Clinical Practice Guidelines:
Management of hepatitis C
virus infection, J Hepatol 2011) suggest that patients with HCV genotypes 1
should receive a weight-based dose of ribavirin of 15 mg/kg body weight per day.
In this study, patients > 80 kg received a maximum RBV dose of 1000 mg/day,
that might justify the absence of RVR in some HCV-1 patients.
MINOR COMMENTS
1. Further data on patient features should be added in table 1 (ALT levels, PLT
count, etc)
2. Were IL28b polymorphisms available in this series of patients ? is so, I
strongly suggest to add these results.
3. the authors should specify that patients were treated with PEG IFN alfa 2b.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
CLAUDIO PUOTI, MD
LIVER UNIT, MARINO, ROMA, ITALY
assistant