Review for 10.1186/s12876-019-1013-1 (2019)

Reviewer ’s report  
 
Title: A case report of psychiatric symptoms following direct -acting antiviral and ribavirin 
combination therapy for chronic hepatitis C in a patient with innate anxiety  
 
Version: 1 Date: 15 Mar 2018  
 
Reviewer: Jennifer Loftis  
 
Reviewer's report:  
 
The authors report on a timely case descr ibing the treatment of chronic HCV with the newer 
direct acting antiviral (DAA) therapy.  
In the abstract it was stated that; "Our case suggests the DAA exacerbate psychiatric symptoms 
in patients with underlying disorders," --but the patient described in t he case report was 
reportedly not experiencing psychiatric symptoms prior to the onset of DAA therapy.  Please 
clarify/re -word "exacerbate psychiatric symptoms".  
Laboratory data on admission was provided in Table 1.  It would be helpful if the title for T able 
1 indicated to which hospital admission the data corresponded.  
The last sentence of the results section states that; "the patient continued to receive liver 
supporting therapies because a mild increase in serum aspartate and alanine aminotransferase 
levels and no clearance of HCV with the interruption of the antiviral therapy." It may be of 
interest to readers to know if there are future plans to attempt another course of antiviral therapy 
(e.g., in combination with mental health support for potential  anxiety disorder), given the high 
incidence of mood disturbances in patients with HCV (as noted in the first sentence of the 
Discussion section).  
Are the methods appropriate and well described?  
If not, pl ease specify what is required in your comments to the authors.  
 
Yes 
 
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 da ta 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.  
 
Not relevant to this manuscript  
 
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 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, writ e '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 interests.  
 
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 Acc ess 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