Title: HCV and HBV Genotypes: Vital in the Progression of HCV/ HBV Co-Infection
Version: 3 Date: 03 Nov 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Abstract Conclusions donot reproduce what hat been presented in the results section There
should be concordance Introduction It should be stressed that usually HCV suppresses HBV
replication and HBV tends to relapse after successful HCV treatment. Moreover that HCV
genotype  D is the most prevalent  in Pakistan ( about 2/3 of patients) Methods Authors should
mention from where patients were recruited and whether they are concecutive Was population
representative of the general Pakistani population? All patients with concurrent liver diseases
were excluded since authors could not tell the cause of liver damage in those cases What
happened in patients with liver steatosis? Especially HCV genotype 3 ( most frequent one in
Pakistan) causes steatosis in the majority of patients Thus what level of steatosis was accepted?
Were there limitations for BMI and waist circumference? Which viruses apart from HIV were
excluded? What about comorbidities and Charlson Comorbidity Index? How often ALT was
measured? What about cases with HBsAg positive and very low HBV-DNA? Is there any
possibility to calculate any liver fibrosis marker? at least FIB-4 or APRI ? Even PT levels?
ALT levels donot tell much about the severity of liver lesion Statistics Multivariated analysis
should be better performed to exclude interferences from other risk factors Chi-square in not
valid for comparisons of more than 2X2 parameters Special chi-square of better ANOVA should
be prefered Results Authors mention that HCV/HBV coinfection in their population was low
Nevertheless 12% is one of the highest described After all any comments belong is the discussion
OR shoud be followed by p-values Only statistical significant factors should be presented in the
text Authors should mention in which occasions HBV dominates over HCV Because usually
HCV is the dominant virus its genotype is sufficient to compare ALT levels HBV-HCV co-
infections  should be mentioned when no virus dominates over the other
Title: HCV and HBV Genotypes: Vital in the Progression of HCV/ HBV Co-Infection
Version: 3 Date: 03 Nov 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Abstract Conclusions donot reproduce what hat been presented in the results section There
should be concordance Introduction It should be stressed that usually HCV suppresses HBV
replication and HBV tends to relapse after successful HCV treatment. Moreover that HCV
genotype  D is the most prevalent  in Pakistan ( about 2/3 of patients) Methods Authors should
mention from where patients were recruited and whether they are concecutive Was population
representative of the general Pakistani population? All patients with concurrent liver diseases
were excluded since authors could not tell the cause of liver damage in those cases What
happened in patients with liver steatosis? Especially HCV genotype 3 ( most frequent one in
Pakistan) causes steatosis in the majority of patients Thus what level of steatosis was accepted?
Were there limitations for BMI and waist circumference? Which viruses apart from HIV were
excluded? What about comorbidities and Charlson Comorbidity Index? How often ALT was
measured? What about cases with HBsAg positive and very low HBV-DNA? Is there any
possibility to calculate any liver fibrosis marker? at least FIB-4 or APRI ? Even PT levels?
ALT levels donot tell much about the severity of liver lesion Statistics Multivariated analysis
should be better performed to exclude interferences from other risk factors Chi-square in not
valid for comparisons of more than 2X2 parameters Special chi-square of better ANOVA should
be prefered Results Authors mention that HCV/HBV coinfection in their population was low
Nevertheless 12% is one of the highest described After all any comments belong is the discussion
OR shoud be followed by p-values Only statistical significant factors should be presented in the
text Authors should mention in which occasions HBV dominates over HCV Because usually
HCV is the dominant virus its genotype is sufficient to compare ALT levels HBV-HCV co-
infections  should be mentioned when no virus dominates over the other
Please review this paper.
user
Title: HCV and HBV Genotypes: Vital in the Progression of HCV/ HBV Co-Infection
Version: 3 Date: 03 Nov 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Abstract Conclusions donot reproduce what hat been presented in the results section There
should be concordance Introduction It should be stressed that usually HCV suppresses HBV
replication and HBV tends to relapse after successful HCV treatment. Moreover that HCV
genotype  D is the most prevalent  in Pakistan ( about 2/3 of patients) Methods Authors should
mention from where patients were recruited and whether they are concecutive Was population
representative of the general Pakistani population? All patients with concurrent liver diseases
were excluded since authors could not tell the cause of liver damage in those cases What
happened in patients with liver steatosis? Especially HCV genotype 3 ( most frequent one in
Pakistan) causes steatosis in the majority of patients Thus what level of steatosis was accepted?
Were there limitations for BMI and waist circumference? Which viruses apart from HIV were
excluded? What about comorbidities and Charlson Comorbidity Index? How often ALT was
measured? What about cases with HBsAg positive and very low HBV-DNA? Is there any
possibility to calculate any liver fibrosis marker? at least FIB-4 or APRI ? Even PT levels?
ALT levels donot tell much about the severity of liver lesion Statistics Multivariated analysis
should be better performed to exclude interferences from other risk factors Chi-square in not
valid for comparisons of more than 2X2 parameters Special chi-square of better ANOVA should
be prefered Results Authors mention that HCV/HBV coinfection in their population was low
Nevertheless 12% is one of the highest described After all any comments belong is the discussion
OR shoud be followed by p-values Only statistical significant factors should be presented in the
text Authors should mention in which occasions HBV dominates over HCV Because usually
HCV is the dominant virus its genotype is sufficient to compare ALT levels HBV-HCV co-
infections  should be mentioned when no virus dominates over the other
assistant