Title: Serum liver fibrosis markers predict hepatic decompensation in compensated cirrhosis
Version: 1 Date: 10 Apr 2023
Reviewer's report:
The authors assessed whether the serum liver fibrosis markers are predictive of the occurrence
of hepatic decompensation in 688 cirrhotic patients with varying etiologies. They showed that
collagen IV (CIV) is reliable predictor for liver decompensation. I have some considerable
concerns.
#1. The etiology of cirrhosis of the patients is heterogeneous. The occurrence of decompensation
differs considerably among the diseases. It is lowest in HBV related cirrhosis (7.2%) and highest
in alcoholic cirrhosis (31.8%). In addition, the triggers of decompensation are likely to differ
among cirrhosis of different etiology. The heterogeneity must have caused confusion of the
results. Thus they should assess the predictors of decompensation in the cirrhosis of single
etiology, especially hepatitis B.
#2. When they study the patients with HBV, they should assess activity of hepatitis, anti-viral
treatment, and viral load (HBsAg, HBeAg,and HBVDNA).
#3. When they study the patients with alcohol abuse, they should assess the abstinence.
#4. They assessed the three different decompensation events (ascites, esophageal bleeding, and
hepatic encephalopathy) simultaneously. The triggers of these three events are likely to differ.
Thus they should assess the predictors of each event separately, especially ascites.
#5. When they study ascites, they should assess alcohol intake and activity of liver disease (AST,
ALT, and GGT)
#6. Table 1. The separate data of three events of decompensation should be added.
Title: Serum liver fibrosis markers predict hepatic decompensation in compensated cirrhosis
Version: 1 Date: 10 Apr 2023
Reviewer's report:
The authors assessed whether the serum liver fibrosis markers are predictive of the occurrence
of hepatic decompensation in 688 cirrhotic patients with varying etiologies. They showed that
collagen IV (CIV) is reliable predictor for liver decompensation. I have some considerable
concerns.
#1. The etiology of cirrhosis of the patients is heterogeneous. The occurrence of decompensation
differs considerably among the diseases. It is lowest in HBV related cirrhosis (7.2%) and highest
in alcoholic cirrhosis (31.8%). In addition, the triggers of decompensation are likely to differ
among cirrhosis of different etiology. The heterogeneity must have caused confusion of the
results. Thus they should assess the predictors of decompensation in the cirrhosis of single
etiology, especially hepatitis B.
#2. When they study the patients with HBV, they should assess activity of hepatitis, anti-viral
treatment, and viral load (HBsAg, HBeAg,and HBVDNA).
#3. When they study the patients with alcohol abuse, they should assess the abstinence.
#4. They assessed the three different decompensation events (ascites, esophageal bleeding, and
hepatic encephalopathy) simultaneously. The triggers of these three events are likely to differ.
Thus they should assess the predictors of each event separately, especially ascites.
#5. When they study ascites, they should assess alcohol intake and activity of liver disease (AST,
ALT, and GGT)
#6. Table 1. The separate data of three events of decompensation should be added.
Please review this paper.
user
Title: Serum liver fibrosis markers predict hepatic decompensation in compensated cirrhosis
Version: 1 Date: 10 Apr 2023
Reviewer's report:
The authors assessed whether the serum liver fibrosis markers are predictive of the occurrence
of hepatic decompensation in 688 cirrhotic patients with varying etiologies. They showed that
collagen IV (CIV) is reliable predictor for liver decompensation. I have some considerable
concerns.
#1. The etiology of cirrhosis of the patients is heterogeneous. The occurrence of decompensation
differs considerably among the diseases. It is lowest in HBV related cirrhosis (7.2%) and highest
in alcoholic cirrhosis (31.8%). In addition, the triggers of decompensation are likely to differ
among cirrhosis of different etiology. The heterogeneity must have caused confusion of the
results. Thus they should assess the predictors of decompensation in the cirrhosis of single
etiology, especially hepatitis B.
#2. When they study the patients with HBV, they should assess activity of hepatitis, anti-viral
treatment, and viral load (HBsAg, HBeAg,and HBVDNA).
#3. When they study the patients with alcohol abuse, they should assess the abstinence.
#4. They assessed the three different decompensation events (ascites, esophageal bleeding, and
hepatic encephalopathy) simultaneously. The triggers of these three events are likely to differ.
Thus they should assess the predictors of each event separately, especially ascites.
#5. When they study ascites, they should assess alcohol intake and activity of liver disease (AST,
ALT, and GGT)
#6. Table 1. The separate data of three events of decompensation should be added.
assistant