Reviewer ’s report  
 
Title: Impact of Antiviral Therapy on Hepatocellular Carcinoma and Mortality in Patients with 
Chronic Hep atitis C: Systematic Review and Meta -analysis  
 
Version: 0 Date: 06 Feb 2017  
 
Reviewer: Marcello Persico  
 
Reviewer's report:  
 
This is a metanalisys aimed to assess the real benefits in terms of risk of developing 
hepatocellular carcinoma of antiviral therapy in HCV infected patients with chronic hepatitis.  
The major problem with this paper relates to the fact that beside the enormous job done in order 
to get the results provided no new information come out regarding the main aim of the paper. In 
fact, recent evidences of the litterature clearly support in a well conducted comparative s tudy 
with the general population that HCV treated patients show the same overall survival of the 
control group. Moreover, while no more decompansation was observed in treated patients the 
risk of HCC was significantly diminished although not completely avo ided.  
Probably by using a metanalisys ewvaluation per single subject the power of the study would be 
higher.  
 
Minor comments:  
Too many tables that keep the study hard to read and understand.  
A more profound revision of the english language shoul be warranted.  
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 ne cessary 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.  
 
No 
 
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 recommend additional statis tical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering t he 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 o f 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.  
 
I declare that I have no competing i nterests'  
 
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: Impact of Antiviral Therapy on Hepatocellular Carcinoma and Mortality in Patients with 
Chronic Hep atitis C: Systematic Review and Meta -analysis  
 
Version: 0 Date: 06 Feb 2017  
 
Reviewer: Marcello Persico  
 
Reviewer's report:  
 
This is a metanalisys aimed to assess the real benefits in terms of risk of developing 
hepatocellular carcinoma of antiviral therapy in HCV infected patients with chronic hepatitis.  
The major problem with this paper relates to the fact that beside the enormous job done in order 
to get the results provided no new information come out regarding the main aim of the paper. In 
fact, recent evidences of the litterature clearly support in a well conducted comparative s tudy 
with the general population that HCV treated patients show the same overall survival of the 
control group. Moreover, while no more decompansation was observed in treated patients the 
risk of HCC was significantly diminished although not completely avo ided.  
Probably by using a metanalisys ewvaluation per single subject the power of the study would be 
higher.  
 
Minor comments:  
Too many tables that keep the study hard to read and understand.  
A more profound revision of the english language shoul be warranted.  
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 ne cessary 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.  
 
No 
 
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 recommend additional statis tical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering t he 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 o f 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.  
 
I declare that I have no competing i nterests'  
 
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: Impact of Antiviral Therapy on Hepatocellular Carcinoma and Mortality in Patients with 
Chronic Hep atitis C: Systematic Review and Meta -analysis  
 
Version: 0 Date: 06 Feb 2017  
 
Reviewer: Marcello Persico  
 
Reviewer's report:  
 
This is a metanalisys aimed to assess the real benefits in terms of risk of developing 
hepatocellular carcinoma of antiviral therapy in HCV infected patients with chronic hepatitis.  
The major problem with this paper relates to the fact that beside the enormous job done in order 
to get the results provided no new information come out regarding the main aim of the paper. In 
fact, recent evidences of the litterature clearly support in a well conducted comparative s tudy 
with the general population that HCV treated patients show the same overall survival of the 
control group. Moreover, while no more decompansation was observed in treated patients the 
risk of HCC was significantly diminished although not completely avo ided.  
Probably by using a metanalisys ewvaluation per single subject the power of the study would be 
higher.  
 
Minor comments:  
Too many tables that keep the study hard to read and understand.  
A more profound revision of the english language shoul be warranted.  
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 ne cessary 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.  
 
No 
 
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 recommend additional statis tical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering t he 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 o f 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.  
 
I declare that I have no competing i nterests'  
 
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