Reviewer's report 
 Autoimmune hepatitis in India: is it uncommon or underdiagnosed Title: 
 2  13 February 2005 Version: Date: 
 PJ Pasricha Reviewer: 
Reviewer's report: 
General 
The authors Title questions whether or not AIH is under diagnosed. This paper, in my opinion, does 
not address this and may need to be modified. Alternatively, a comparison of pre-referral and post-referral diagnoses should be made. ------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can 
be reached) 1. The authors need to emphasize how their findings differ from the previous reports from India and speculate on potential reasons for this discrepancy. May expand on the discussion of what the low 
prevalence may be attributed to, consider discussing HLA alleles and summarized literature on 
geographic variation in prevalence.Further, what can the average hepatologist in India learn from this paper about the diagnosis and treatment of AIH that are worth emphasizing? 2. The outcome after treatment is an important aspect for a paper describing the experience with a 
disease. It appears that not all patients were treated- why? The response to treatment also appears 
less favorable compared to the literature- some comments are needed on this.It seems there is 
more discussion of the adverse events with treatment than summarizing the successes or failures in 
the Treatment Outcomes section. More information should be provided if available. 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the 
author can be trusted to correct) This section may be condensed into a paragraph form without headings. 1. May state whether or not the outlined immunofluorescence techniques outlined are standard 
commonly used methods. 
2. Did all patients undergo upper endoscopy? 3. A definition of Acute and chronic hepatitis may be helpful if included here. 4. In the statistical analysis section “two groups” are referred to, is it important to clarify what these 
groups are? 
5. The sentence “Jaundice was usually mild, with a mean of 5.2 mg/dL.” should be taken out since the word bilirubin is omitted. Again this paragraph should talk more about physical findings since there is another section for Laboratory parameters. Or are the authors referring to 55.2% of patients 
with Jaundice? 
6. Others: 
-Indentation of Third paragraph in introduction -In the section of “treatment outcomes”, the second sentence begins with “Off” which should be 
changed to Of. 
-A reference to Table 3 should be included in Laboratory Parameters” section 
-The last sentence of the first paragraph may be revised or reworded to accurately reflect the natural 
history of autoimmune liver disease 
-In discussion of bilirubin, mg% is written twice. This should be changed to mg/dL. 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Accept after minor essential revisions What next?: 
 An article whose findings are important to those with closely related research Level of interest: 
interests 
 Needs some language corrections before being published Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I have no competing interests 
Reviewer's report 
 Autoimmune hepatitis in India: is it uncommon or underdiagnosed Title: 
 2  13 February 2005 Version: Date: 
 PJ Pasricha Reviewer: 
Reviewer's report: 
General 
The authors Title questions whether or not AIH is under diagnosed. This paper, in my opinion, does 
not address this and may need to be modified. Alternatively, a comparison of pre-referral and post-referral diagnoses should be made. ------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can 
be reached) 1. The authors need to emphasize how their findings differ from the previous reports from India and speculate on potential reasons for this discrepancy. May expand on the discussion of what the low 
prevalence may be attributed to, consider discussing HLA alleles and summarized literature on 
geographic variation in prevalence.Further, what can the average hepatologist in India learn from this paper about the diagnosis and treatment of AIH that are worth emphasizing? 2. The outcome after treatment is an important aspect for a paper describing the experience with a 
disease. It appears that not all patients were treated- why? The response to treatment also appears 
less favorable compared to the literature- some comments are needed on this.It seems there is 
more discussion of the adverse events with treatment than summarizing the successes or failures in 
the Treatment Outcomes section. More information should be provided if available. 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the 
author can be trusted to correct) This section may be condensed into a paragraph form without headings. 1. May state whether or not the outlined immunofluorescence techniques outlined are standard 
commonly used methods. 
2. Did all patients undergo upper endoscopy? 3. A definition of Acute and chronic hepatitis may be helpful if included here. 4. In the statistical analysis section “two groups” are referred to, is it important to clarify what these 
groups are? 
5. The sentence “Jaundice was usually mild, with a mean of 5.2 mg/dL.” should be taken out since the word bilirubin is omitted. Again this paragraph should talk more about physical findings since there is another section for Laboratory parameters. Or are the authors referring to 55.2% of patients 
with Jaundice? 
6. Others: 
-Indentation of Third paragraph in introduction -In the section of “treatment outcomes”, the second sentence begins with “Off” which should be 
changed to Of. 
-A reference to Table 3 should be included in Laboratory Parameters” section 
-The last sentence of the first paragraph may be revised or reworded to accurately reflect the natural 
history of autoimmune liver disease 
-In discussion of bilirubin, mg% is written twice. This should be changed to mg/dL. 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Accept after minor essential revisions What next?: 
 An article whose findings are important to those with closely related research Level of interest: 
interests 
 Needs some language corrections before being published Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I have no competing interests 
Please review this paper.
user
Reviewer's report 
 Autoimmune hepatitis in India: is it uncommon or underdiagnosed Title: 
 2  13 February 2005 Version: Date: 
 PJ Pasricha Reviewer: 
Reviewer's report: 
General 
The authors Title questions whether or not AIH is under diagnosed. This paper, in my opinion, does 
not address this and may need to be modified. Alternatively, a comparison of pre-referral and post-referral diagnoses should be made. ------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can 
be reached) 1. The authors need to emphasize how their findings differ from the previous reports from India and speculate on potential reasons for this discrepancy. May expand on the discussion of what the low 
prevalence may be attributed to, consider discussing HLA alleles and summarized literature on 
geographic variation in prevalence.Further, what can the average hepatologist in India learn from this paper about the diagnosis and treatment of AIH that are worth emphasizing? 2. The outcome after treatment is an important aspect for a paper describing the experience with a 
disease. It appears that not all patients were treated- why? The response to treatment also appears 
less favorable compared to the literature- some comments are needed on this.It seems there is 
more discussion of the adverse events with treatment than summarizing the successes or failures in 
the Treatment Outcomes section. More information should be provided if available. 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the 
author can be trusted to correct) This section may be condensed into a paragraph form without headings. 1. May state whether or not the outlined immunofluorescence techniques outlined are standard 
commonly used methods. 
2. Did all patients undergo upper endoscopy? 3. A definition of Acute and chronic hepatitis may be helpful if included here. 4. In the statistical analysis section “two groups” are referred to, is it important to clarify what these 
groups are? 
5. The sentence “Jaundice was usually mild, with a mean of 5.2 mg/dL.” should be taken out since the word bilirubin is omitted. Again this paragraph should talk more about physical findings since there is another section for Laboratory parameters. Or are the authors referring to 55.2% of patients 
with Jaundice? 
6. Others: 
-Indentation of Third paragraph in introduction -In the section of “treatment outcomes”, the second sentence begins with “Off” which should be 
changed to Of. 
-A reference to Table 3 should be included in Laboratory Parameters” section 
-The last sentence of the first paragraph may be revised or reworded to accurately reflect the natural 
history of autoimmune liver disease 
-In discussion of bilirubin, mg% is written twice. This should be changed to mg/dL. 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Accept after minor essential revisions What next?: 
 An article whose findings are important to those with closely related research Level of interest: 
interests 
 Needs some language corrections before being published Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I have no competing interests 
assistant