Reviewer’s report
Title: Causative factors of liver fibrosis in HIV-infected patients. A single center study.
Version: 0 Date: 15 Apr 2019
Reviewer: Mark H. Kuniholm
Reviewer's report:
This is a single center study of a majority middle-aged MSM study population. The careful description
of the study population in Table 1 is a strength, including estimates of duration of time under specific
CD4 count thresholds.  Most Table 1s that I see include the median (IQR) or the mean and standard
deviation but not both. I generally prefer the median to the mean. I like, though, presentation of the
ranges in Table 1. The authors should spell out the word "laboratory in the Table 1 title. (i.e., "Patients
lab results at study entry"). Also, the authors might avoid such terms as "at study entry" which suggests
that patients are being enrolled into a cohort study. If I am not mistaken this is a cross-sectional study. 
Definitions for the liver-related events presented in Table 2 are not provided. Similarly, diagnostic
protocols for some other study variables (e.g., alcohol abuse) are not provided. 
Table 3 should be corrected to include effect estimates and confidence intervals in addition to p values.
Tables 4 and 5 should be corrected to show odds ratios and 95% confidence intervals. I don't need to
see the Chi-square statistic.  
The rationales  for analytic  decisions  should be explained. For example, following assembly of a
multivariable model with all studied variables, the authors create a second model excluding AST, ALT,
γ-GT, ALP, total and direct Bilirubin serum levels, platelets' count, total cholesterol, triglycerides and
albumin serum levels. My guess is that the authors believe that some (or all?) of these laboratory
variables may be on the causal pathway between well-defined risk factors (e.g., HCV infection) and
TE-defined liver stiffness. This hypothesis - if it is to be tested - should be explicitly stated and the
analytic process be made more transparent.  
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
Are you able to assess any statistics in the manuscript or would you recommend an
additional statistical review?
If an additional statistical review is recommended, please specify what aspects require further
assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this
manuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?
6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below.
If your reply is yes to any, please give details below.
I declare that I have no competing interests
I agree to the open peer review policy of the journal. I understand that my name will be included
on my report to the authors and, if the manuscript is accepted for publication, my named report
including any attachments I upload will be posted on the website along with the authors'
responses. I agree for my report to be made available under an Open Access Creative Commons
CC-BY license (http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments
which I do not wish to be included in my named report can be included as confidential comments
to the editors, which will not be published.
I agree to the open peer review policy of the journal
Reviewer’s report
Title: Causative factors of liver fibrosis in HIV-infected patients. A single center study.
Version: 0 Date: 15 Apr 2019
Reviewer: Mark H. Kuniholm
Reviewer's report:
This is a single center study of a majority middle-aged MSM study population. The careful description
of the study population in Table 1 is a strength, including estimates of duration of time under specific
CD4 count thresholds.  Most Table 1s that I see include the median (IQR) or the mean and standard
deviation but not both. I generally prefer the median to the mean. I like, though, presentation of the
ranges in Table 1. The authors should spell out the word "laboratory in the Table 1 title. (i.e., "Patients
lab results at study entry"). Also, the authors might avoid such terms as "at study entry" which suggests
that patients are being enrolled into a cohort study. If I am not mistaken this is a cross-sectional study. 
Definitions for the liver-related events presented in Table 2 are not provided. Similarly, diagnostic
protocols for some other study variables (e.g., alcohol abuse) are not provided. 
Table 3 should be corrected to include effect estimates and confidence intervals in addition to p values.
Tables 4 and 5 should be corrected to show odds ratios and 95% confidence intervals. I don't need to
see the Chi-square statistic.  
The rationales  for analytic  decisions  should be explained. For example, following assembly of a
multivariable model with all studied variables, the authors create a second model excluding AST, ALT,
γ-GT, ALP, total and direct Bilirubin serum levels, platelets' count, total cholesterol, triglycerides and
albumin serum levels. My guess is that the authors believe that some (or all?) of these laboratory
variables may be on the causal pathway between well-defined risk factors (e.g., HCV infection) and
TE-defined liver stiffness. This hypothesis - if it is to be tested - should be explicitly stated and the
analytic process be made more transparent.  
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
Are you able to assess any statistics in the manuscript or would you recommend an
additional statistical review?
If an additional statistical review is recommended, please specify what aspects require further
assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this
manuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?
6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below.
If your reply is yes to any, please give details below.
I declare that I have no competing interests
I agree to the open peer review policy of the journal. I understand that my name will be included
on my report to the authors and, if the manuscript is accepted for publication, my named report
including any attachments I upload will be posted on the website along with the authors'
responses. I agree for my report to be made available under an Open Access Creative Commons
CC-BY license (http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments
which I do not wish to be included in my named report can be included as confidential comments
to the editors, which will not be published.
I agree to the open peer review policy of the journal
Please review this paper.
user
Reviewer’s report
Title: Causative factors of liver fibrosis in HIV-infected patients. A single center study.
Version: 0 Date: 15 Apr 2019
Reviewer: Mark H. Kuniholm
Reviewer's report:
This is a single center study of a majority middle-aged MSM study population. The careful description
of the study population in Table 1 is a strength, including estimates of duration of time under specific
CD4 count thresholds.  Most Table 1s that I see include the median (IQR) or the mean and standard
deviation but not both. I generally prefer the median to the mean. I like, though, presentation of the
ranges in Table 1. The authors should spell out the word "laboratory in the Table 1 title. (i.e., "Patients
lab results at study entry"). Also, the authors might avoid such terms as "at study entry" which suggests
that patients are being enrolled into a cohort study. If I am not mistaken this is a cross-sectional study. 
Definitions for the liver-related events presented in Table 2 are not provided. Similarly, diagnostic
protocols for some other study variables (e.g., alcohol abuse) are not provided. 
Table 3 should be corrected to include effect estimates and confidence intervals in addition to p values.
Tables 4 and 5 should be corrected to show odds ratios and 95% confidence intervals. I don't need to
see the Chi-square statistic.  
The rationales  for analytic  decisions  should be explained. For example, following assembly of a
multivariable model with all studied variables, the authors create a second model excluding AST, ALT,
γ-GT, ALP, total and direct Bilirubin serum levels, platelets' count, total cholesterol, triglycerides and
albumin serum levels. My guess is that the authors believe that some (or all?) of these laboratory
variables may be on the causal pathway between well-defined risk factors (e.g., HCV infection) and
TE-defined liver stiffness. This hypothesis - if it is to be tested - should be explicitly stated and the
analytic process be made more transparent.  
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
Are you able to assess any statistics in the manuscript or would you recommend an
additional statistical review?
If an additional statistical review is recommended, please specify what aspects require further
assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this
manuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?
6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below.
If your reply is yes to any, please give details below.
I declare that I have no competing interests
I agree to the open peer review policy of the journal. I understand that my name will be included
on my report to the authors and, if the manuscript is accepted for publication, my named report
including any attachments I upload will be posted on the website along with the authors'
responses. I agree for my report to be made available under an Open Access Creative Commons
CC-BY license (http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments
which I do not wish to be included in my named report can be included as confidential comments
to the editors, which will not be published.
I agree to the open peer review policy of the journal
assistant