Title: Patients with chronic hepatitis B who have persistently normal alanine aminotransferase
or aged < 30 years may exhibit significant histologic damage
Version: 2 Date: 10 Feb 2024
Reviewer:  Emanuel K. Manesis
Reviewer's report:
1. (Line 1): The authors should replace everywhere in the text the phrase “normal ALT” with
“persistently normal ALT”.
2.  Line 112-113): Authors should mention the number of patients tested with the “pre-2002
Digene test” and the current Cobas-Monitor test. They must, also,  define the commercial source
of both tests and their respective lower level of detectability.
3. (Line 124, Statistical analysis): The authors are advised to compare patients with undetectable
HBV DNA by the Digene method to those with # 2000 IU/mL by Cobas-Monitor. There is a
strong possibility that finding high percentages of advanced fibrosis and necroinflammation in
their cohort of naïve HBV-infected patients with persistently normal ALT is due to inadverted
inclusion of chronic hepatitis B patients with high HBV DNA in the older sample.
Title: Patients with chronic hepatitis B who have persistently normal alanine aminotransferase
or aged < 30 years may exhibit significant histologic damage
Version: 2 Date: 10 Feb 2024
Reviewer:  Emanuel K. Manesis
Reviewer's report:
1. (Line 1): The authors should replace everywhere in the text the phrase “normal ALT” with
“persistently normal ALT”.
2.  Line 112-113): Authors should mention the number of patients tested with the “pre-2002
Digene test” and the current Cobas-Monitor test. They must, also,  define the commercial source
of both tests and their respective lower level of detectability.
3. (Line 124, Statistical analysis): The authors are advised to compare patients with undetectable
HBV DNA by the Digene method to those with # 2000 IU/mL by Cobas-Monitor. There is a
strong possibility that finding high percentages of advanced fibrosis and necroinflammation in
their cohort of naïve HBV-infected patients with persistently normal ALT is due to inadverted
inclusion of chronic hepatitis B patients with high HBV DNA in the older sample.
Please review this paper.
user
Title: Patients with chronic hepatitis B who have persistently normal alanine aminotransferase
or aged < 30 years may exhibit significant histologic damage
Version: 2 Date: 10 Feb 2024
Reviewer:  Emanuel K. Manesis
Reviewer's report:
1. (Line 1): The authors should replace everywhere in the text the phrase “normal ALT” with
“persistently normal ALT”.
2.  Line 112-113): Authors should mention the number of patients tested with the “pre-2002
Digene test” and the current Cobas-Monitor test. They must, also,  define the commercial source
of both tests and their respective lower level of detectability.
3. (Line 124, Statistical analysis): The authors are advised to compare patients with undetectable
HBV DNA by the Digene method to those with # 2000 IU/mL by Cobas-Monitor. There is a
strong possibility that finding high percentages of advanced fibrosis and necroinflammation in
their cohort of naïve HBV-infected patients with persistently normal ALT is due to inadverted
inclusion of chronic hepatitis B patients with high HBV DNA in the older sample.
assistant