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Reply. Murayama and colleagues question financial conflicts of interest (FCOI) of authors as well as level of evidence for recommendations in the American Association for the Study of Liver Diseases (AASLD) / Infectious Diseases Society of America (IDSA) Hepatitis C (HCV) guidance. The inaugural AASLD / IDSA HCV writing panel was selected in 2013, in consultation with the National Institutes of Health and Centers for Disease Control and Prevention, to provide guidance in a time of rapidly evolving treatment algorithms. Today, the guidance remains an essential online tool for HCV providers and has been referenced over 3.9 million times since inception. The AASLD and IDSA maintain strong endorsement of the HCV guidance and wish to express disagreement with the Murayama correspondence, which interprets data out of context, leading to unsubstantiated conclusions.

Reply. We are disappointed that the Cochrane Group remains unconvinced that sustained virologic response (SVR) is a validated surrogate outcome and that direct-acting antiviral agents (DAAs) have been demonstrated to improve clinical as well as patient-reported outcomes in patients with chronic hepatitis C. Since our commentary in 2017, there have been many more studies supporting the benefits of SVR and DAA therapies, including a decline in patients added to the waiting list for liver transplantation for hepatitis C. We recognize that randomized controlled trials are the gold standards for showing the benefits of new treatments but given the robust evidence from clinical trials and observational studies all over the world, we do not believe that it is ethical to contemplate withholding clinically proven beneficial therapy. We stand by our associations' recommendations that all patients with chronic hepatitis C should be treated. This article is protected by copyright. All rights reserved.

Reply. We sincerely thank Dr. Sikarin Upala for his interest in our article and for sharing his experience in the treatment of nonalcoholic fatty liver disease (NAFLD). NAFLD is prevalent in patients with type 2 diabetes mellitus (T2DM), yet only preliminary evidence are available on the effect of anti-diabetic agents to NAFLD in T2DM patients. According to clinical practice guidelines for NAFLD management (1,2) , no pharmacotherapies are approved for the treatment of NAFLD. There is neither proper therapy for patients with T2DM and NAFLD. So we designed this 26-week comparative trial, aiming to evaluate the efficacy and safety of liraglutide, sitagliptin, and insulin glargine as an add-on treatment to metformin in patients with T2DM and NAFLD. This article is protected by copyright. All rights reserved.