Title: Evaluation of autoimmune liver disease natural history in patients referred to Middle East
Liver Diseases (MELD) center
Version: 0 Date: 14 Sep 2023
Reviewer's report:
I was really glad to read this study on the prevalence and clinical manifestations on autoimmune
liver disease in Iran. The stud y provides important information on the field, however it can
benefit from changes.
1)Title is accurate and reflects the content
2)Abstract is satisfactory
3)Introduction should focus on the fact that very few studies on this field have been published
from this region.
4) Patients and Methods should be better organized and definitions should be better explained.
How acute hepatitis is defined (levels of AST/ALT and Bil), what about the IgG on AIH patients,
how was cirrhosis defined?). Moreover, with which score was the outcome of PBC evaluated,
what do the authors mean with response in PSC? Autoantibodies and methods to determine them
should be clearly mentioned. How many patients had liver biopsy?
Results should also be better analyzed and presented. There are more patients with AIH than
PBC which is rare, how could we explain this? Separate paragraphs should be made for baseline
characteristics in each group, histological characteristics, treatment and outcome. The Figures
are necessary but should be designed better (two versions of the same graph are not needed and
in bars exceed the limits of the graph, maybe SE and not SD should be used).
How was reversal of cirrhosis defined? Was liver elastography available?
Discussion should include conclusions about how and if the results come in agreement with what
is observed in Europe and USA, where differences could be attributed and how results could be
affected from other reasons (economical, ethical, religious etc) in this geographical region.
To summarize, I think that it is very interesting to present what happens up to know with
autoimmune liver disease in this part of the world, but data should be better presented in order
to cover this field sufficiently.
Title: Evaluation of autoimmune liver disease natural history in patients referred to Middle East
Liver Diseases (MELD) center
Version: 0 Date: 14 Sep 2023
Reviewer's report:
I was really glad to read this study on the prevalence and clinical manifestations on autoimmune
liver disease in Iran. The stud y provides important information on the field, however it can
benefit from changes.
1)Title is accurate and reflects the content
2)Abstract is satisfactory
3)Introduction should focus on the fact that very few studies on this field have been published
from this region.
4) Patients and Methods should be better organized and definitions should be better explained.
How acute hepatitis is defined (levels of AST/ALT and Bil), what about the IgG on AIH patients,
how was cirrhosis defined?). Moreover, with which score was the outcome of PBC evaluated,
what do the authors mean with response in PSC? Autoantibodies and methods to determine them
should be clearly mentioned. How many patients had liver biopsy?
Results should also be better analyzed and presented. There are more patients with AIH than
PBC which is rare, how could we explain this? Separate paragraphs should be made for baseline
characteristics in each group, histological characteristics, treatment and outcome. The Figures
are necessary but should be designed better (two versions of the same graph are not needed and
in bars exceed the limits of the graph, maybe SE and not SD should be used).
How was reversal of cirrhosis defined? Was liver elastography available?
Discussion should include conclusions about how and if the results come in agreement with what
is observed in Europe and USA, where differences could be attributed and how results could be
affected from other reasons (economical, ethical, religious etc) in this geographical region.
To summarize, I think that it is very interesting to present what happens up to know with
autoimmune liver disease in this part of the world, but data should be better presented in order
to cover this field sufficiently.
Please review this paper.
user
Title: Evaluation of autoimmune liver disease natural history in patients referred to Middle East
Liver Diseases (MELD) center
Version: 0 Date: 14 Sep 2023
Reviewer's report:
I was really glad to read this study on the prevalence and clinical manifestations on autoimmune
liver disease in Iran. The stud y provides important information on the field, however it can
benefit from changes.
1)Title is accurate and reflects the content
2)Abstract is satisfactory
3)Introduction should focus on the fact that very few studies on this field have been published
from this region.
4) Patients and Methods should be better organized and definitions should be better explained.
How acute hepatitis is defined (levels of AST/ALT and Bil), what about the IgG on AIH patients,
how was cirrhosis defined?). Moreover, with which score was the outcome of PBC evaluated,
what do the authors mean with response in PSC? Autoantibodies and methods to determine them
should be clearly mentioned. How many patients had liver biopsy?
Results should also be better analyzed and presented. There are more patients with AIH than
PBC which is rare, how could we explain this? Separate paragraphs should be made for baseline
characteristics in each group, histological characteristics, treatment and outcome. The Figures
are necessary but should be designed better (two versions of the same graph are not needed and
in bars exceed the limits of the graph, maybe SE and not SD should be used).
How was reversal of cirrhosis defined? Was liver elastography available?
Discussion should include conclusions about how and if the results come in agreement with what
is observed in Europe and USA, where differences could be attributed and how results could be
affected from other reasons (economical, ethical, religious etc) in this geographical region.
To summarize, I think that it is very interesting to present what happens up to know with
autoimmune liver disease in this part of the world, but data should be better presented in order
to cover this field sufficiently.
assistant