Reviewer’s report
Title:  High rates of cirrhosis and severe clinical events in patients with HBV/HDV co-infection:
Longitudinal analysis of a German cohort.
Version: 0 Date: 21 Jan 2019
Reviewer: Reviewer 2
Reviewer's report:
PEER REVIEWER ASSESSMENTS: 
OBJECTIVE - Full research articles: is there a clear objective that addresses  a testable research
question(s) (brief or other article types: is there a clear objective)?
No - there are minor issues
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the
objective?
No - there are minor issues
EXECUTION - Are the experiments and analyses performed with technical rigor to allow confidence
in the results?
No - there are minor issues
Statistics - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION  -  Is  the  current  interpretation/discussion  of  the  results  reasonable  and  not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically sound? If
not, can revisions be made to make the work technically sound?
Maybe - with major revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: The analysis provided by the authors includes a large cohort of patients,
spanning 8 and half years in their Hospital activity in treating patients with hepatitis B (and D). Such
large group of patients and their clinical parameter description provide an interesting retrospective
analysis of current therapeutical approach in Germany. However, the major limit of such manuscript
stands  on  the  sole  description  of  different  clinical  parameters  with  no  additional  analysis  or
investigation. No new information is provided. Authors' analysis well describes current situation and
may  provide  important  tool  to  future  treatment,  but  additional  measurements  (on  biomolecular,
histological analysis on bioptic material, ...) are strongly recommended 
REQUESTED REVISIONS: 
As previously stated, additional analysis on patients' material (serum, tissue) is highly recommended.
Retrospective analysis based only on clinical parameters are interesting but limited.  
Note: This reviewer report can be downloaded - see attached pdf file.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
No
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  require  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, either 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 relating 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 interests?
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.
This reviewer has been recruited by a partner organization, Research Square. Reviewers with declared
or  apparent  competing  interests  are  not  utilized  for  these  reviews.  This  reviewer  has  agreed  to
publication of their comments online under a Creative Commons Attribution License attributed to
Research Square and was paid a small honorarium for completing the review  within a specified
timeframe. Honoraria for reviews such as this are paid regardless of the reviewer recommendation.
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 that 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:  High rates of cirrhosis and severe clinical events in patients with HBV/HDV co-infection:
Longitudinal analysis of a German cohort.
Version: 0 Date: 21 Jan 2019
Reviewer: Reviewer 2
Reviewer's report:
PEER REVIEWER ASSESSMENTS: 
OBJECTIVE - Full research articles: is there a clear objective that addresses  a testable research
question(s) (brief or other article types: is there a clear objective)?
No - there are minor issues
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the
objective?
No - there are minor issues
EXECUTION - Are the experiments and analyses performed with technical rigor to allow confidence
in the results?
No - there are minor issues
Statistics - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION  -  Is  the  current  interpretation/discussion  of  the  results  reasonable  and  not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically sound? If
not, can revisions be made to make the work technically sound?
Maybe - with major revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: The analysis provided by the authors includes a large cohort of patients,
spanning 8 and half years in their Hospital activity in treating patients with hepatitis B (and D). Such
large group of patients and their clinical parameter description provide an interesting retrospective
analysis of current therapeutical approach in Germany. However, the major limit of such manuscript
stands  on  the  sole  description  of  different  clinical  parameters  with  no  additional  analysis  or
investigation. No new information is provided. Authors' analysis well describes current situation and
may  provide  important  tool  to  future  treatment,  but  additional  measurements  (on  biomolecular,
histological analysis on bioptic material, ...) are strongly recommended 
REQUESTED REVISIONS: 
As previously stated, additional analysis on patients' material (serum, tissue) is highly recommended.
Retrospective analysis based only on clinical parameters are interesting but limited.  
Note: This reviewer report can be downloaded - see attached pdf file.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
No
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  require  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, either 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 relating 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 interests?
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.
This reviewer has been recruited by a partner organization, Research Square. Reviewers with declared
or  apparent  competing  interests  are  not  utilized  for  these  reviews.  This  reviewer  has  agreed  to
publication of their comments online under a Creative Commons Attribution License attributed to
Research Square and was paid a small honorarium for completing the review  within a specified
timeframe. Honoraria for reviews such as this are paid regardless of the reviewer recommendation.
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 that 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:  High rates of cirrhosis and severe clinical events in patients with HBV/HDV co-infection:
Longitudinal analysis of a German cohort.
Version: 0 Date: 21 Jan 2019
Reviewer: Reviewer 2
Reviewer's report:
PEER REVIEWER ASSESSMENTS: 
OBJECTIVE - Full research articles: is there a clear objective that addresses  a testable research
question(s) (brief or other article types: is there a clear objective)?
No - there are minor issues
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the
objective?
No - there are minor issues
EXECUTION - Are the experiments and analyses performed with technical rigor to allow confidence
in the results?
No - there are minor issues
Statistics - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION  -  Is  the  current  interpretation/discussion  of  the  results  reasonable  and  not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically sound? If
not, can revisions be made to make the work technically sound?
Maybe - with major revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: The analysis provided by the authors includes a large cohort of patients,
spanning 8 and half years in their Hospital activity in treating patients with hepatitis B (and D). Such
large group of patients and their clinical parameter description provide an interesting retrospective
analysis of current therapeutical approach in Germany. However, the major limit of such manuscript
stands  on  the  sole  description  of  different  clinical  parameters  with  no  additional  analysis  or
investigation. No new information is provided. Authors' analysis well describes current situation and
may  provide  important  tool  to  future  treatment,  but  additional  measurements  (on  biomolecular,
histological analysis on bioptic material, ...) are strongly recommended 
REQUESTED REVISIONS: 
As previously stated, additional analysis on patients' material (serum, tissue) is highly recommended.
Retrospective analysis based only on clinical parameters are interesting but limited.  
Note: This reviewer report can be downloaded - see attached pdf file.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
No
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  require  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, either 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 relating 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 interests?
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.
This reviewer has been recruited by a partner organization, Research Square. Reviewers with declared
or  apparent  competing  interests  are  not  utilized  for  these  reviews.  This  reviewer  has  agreed  to
publication of their comments online under a Creative Commons Attribution License attributed to
Research Square and was paid a small honorarium for completing the review  within a specified
timeframe. Honoraria for reviews such as this are paid regardless of the reviewer recommendation.
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 that 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