Title: Efficacy and safety of tenofovir disoproxil fumarate versus entecavir in the treatment of
acute-on-chronic liver failure with hepatitis B: a systematic review and meta-analysis
Version: 1 Date: 10 Jul 2023
Reviewer:  Hee Bok Chae
Reviewer's report:
1. this is systematic review  about the efficacy of antiviral drug for ACLF patients.
2. this is an well organized and well written study with negative result.
3. please show the analysis result for safety issue about TDF drug.
4. Serum surface antigen conversion
In the study by Wan et al. [21], two HBeAg+ patients in the ETV group and four HBeAg+
patients in the TDF group survived for three months. Of these patients, 4 (100%; 4/4) in the
ETV group (0%; 0/2) and the TDF group (100%; 4/4) had no HBeAg loss (p = 0.067).
my comment: this sentence makes me confusing. How many patients (or percentage) get HBsAg
loss in each group? please express the HBsAg loss rate as positive, not by negative.
5. Safety of TDF and TAF in HBV-ACLF
Two studies by Zhang et al. and Li et al. [20, 22] provided changes in eGFR over four weeks, but
no significant differences between the two groups were found in their respective reports. Li et
al. [20] focused on eGFR at 12 and 48 weeks and found that eGFR levels decreased differently
from baseline at 48 weeks in the TDF and ETV groups, and the decrease ( in the TDF group)
was greater in the TDF group than in the ETV group. my comment: ( ) should be deleted.
6. Conclusion
In summary, our results suggest that TDF treatment of HBV-ACLF is similar to ETV in
improving survival, liver function, and virological response but has a more pronounced effect
on renal function during long-term use than ETV. In the future, more studies are need, especially
RCTs. my comment: please show the results. In Result, safety; there was only a description
without data.
Title: Efficacy and safety of tenofovir disoproxil fumarate versus entecavir in the treatment of
acute-on-chronic liver failure with hepatitis B: a systematic review and meta-analysis
Version: 1 Date: 10 Jul 2023
Reviewer:  Hee Bok Chae
Reviewer's report:
1. this is systematic review  about the efficacy of antiviral drug for ACLF patients.
2. this is an well organized and well written study with negative result.
3. please show the analysis result for safety issue about TDF drug.
4. Serum surface antigen conversion
In the study by Wan et al. [21], two HBeAg+ patients in the ETV group and four HBeAg+
patients in the TDF group survived for three months. Of these patients, 4 (100%; 4/4) in the
ETV group (0%; 0/2) and the TDF group (100%; 4/4) had no HBeAg loss (p = 0.067).
my comment: this sentence makes me confusing. How many patients (or percentage) get HBsAg
loss in each group? please express the HBsAg loss rate as positive, not by negative.
5. Safety of TDF and TAF in HBV-ACLF
Two studies by Zhang et al. and Li et al. [20, 22] provided changes in eGFR over four weeks, but
no significant differences between the two groups were found in their respective reports. Li et
al. [20] focused on eGFR at 12 and 48 weeks and found that eGFR levels decreased differently
from baseline at 48 weeks in the TDF and ETV groups, and the decrease ( in the TDF group)
was greater in the TDF group than in the ETV group. my comment: ( ) should be deleted.
6. Conclusion
In summary, our results suggest that TDF treatment of HBV-ACLF is similar to ETV in
improving survival, liver function, and virological response but has a more pronounced effect
on renal function during long-term use than ETV. In the future, more studies are need, especially
RCTs. my comment: please show the results. In Result, safety; there was only a description
without data.
Please review this paper.
user
Title: Efficacy and safety of tenofovir disoproxil fumarate versus entecavir in the treatment of
acute-on-chronic liver failure with hepatitis B: a systematic review and meta-analysis
Version: 1 Date: 10 Jul 2023
Reviewer:  Hee Bok Chae
Reviewer's report:
1. this is systematic review  about the efficacy of antiviral drug for ACLF patients.
2. this is an well organized and well written study with negative result.
3. please show the analysis result for safety issue about TDF drug.
4. Serum surface antigen conversion
In the study by Wan et al. [21], two HBeAg+ patients in the ETV group and four HBeAg+
patients in the TDF group survived for three months. Of these patients, 4 (100%; 4/4) in the
ETV group (0%; 0/2) and the TDF group (100%; 4/4) had no HBeAg loss (p = 0.067).
my comment: this sentence makes me confusing. How many patients (or percentage) get HBsAg
loss in each group? please express the HBsAg loss rate as positive, not by negative.
5. Safety of TDF and TAF in HBV-ACLF
Two studies by Zhang et al. and Li et al. [20, 22] provided changes in eGFR over four weeks, but
no significant differences between the two groups were found in their respective reports. Li et
al. [20] focused on eGFR at 12 and 48 weeks and found that eGFR levels decreased differently
from baseline at 48 weeks in the TDF and ETV groups, and the decrease ( in the TDF group)
was greater in the TDF group than in the ETV group. my comment: ( ) should be deleted.
6. Conclusion
In summary, our results suggest that TDF treatment of HBV-ACLF is similar to ETV in
improving survival, liver function, and virological response but has a more pronounced effect
on renal function during long-term use than ETV. In the future, more studies are need, especially
RCTs. my comment: please show the results. In Result, safety; there was only a description
without data.
assistant