Reviewer ’s report  
 
Title: Hepatitis B virus -associated hepatocellular carcinoma in South Africa in the era of HIV  
 
Version: 3 Date: 21 Jan 2020  
 
Reviewer's report:  
 
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research 
question(s) (brief or other article types: is there a cle ar objective)?  
Yes - there is a clear objective  
 
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the 
objective?  
No - there are minor issues  
 
EXECUTION - Are the experiments and analyses performed with technical rigor to allow 
confidence in the results?  
No - there are minor issues  
 
STATISTICS - Is the use of statistics in the manuscript appropriate?  
Yes - appropriate statistical analyses have been used in the study  
 
INTERPRETATION - Is the current interpretation/d iscussion of the results reasonable and not 
overstated?  
No - there are minor issues  
 
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically 
sound? If not, can revisions be made to make the work technically sound?  
Probably - with min or revisions  
 
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS:  
The study was basically a repeat of earlier studies that investigated the relationship of HBV/HIV 
coinfection to the development of HCC (e.g., 10.1371/journal.pone.0196057; 10.1186/s12885 -
017-3915 -z).  There is nothing here that is really novel to report, and what was found is that co -
infection did not significantly change the survival of patients with HCC.  The only features that 
were novel was the relationship between HBV genotype A with HCC.  Thi s observation differed 
from that reported elsewhere (10.1016/j.bpg.2017.04.010), and it is not clear why these differ.  
The Discussion section brings up many topics in the paper which were not statistically different 
in the Results section, making this sec tion of the paper unusually long.  It is suggested that the 
Discussion focus upon the characteristics that are statistically different when single infections are 
compared to co -infections.  
 
REQUESTED REVISIONS:  
The authors do not really point out what the re is that is unique about their studies, and the 
Discussion is diffuse.  
ADDITIONAL REQUESTS/SUGGESTIONS:  
Seems like the major conclusion of the paper is that HIV co -infection really does not matter 
when it comes to survival of HBV/HIV co -infected patients.  
 
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 speci fy which controls are required in your comments to the authors.  
 
No 
 
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  
Pleas e indicate the quality of language in the manuscript:  
 
Acceptable  
 
 
 
 
 
 
 
 
 
 
 
 
 
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, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares  in an organisation t hat 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 recei ved 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.  
 
This reviewer has been recruited by a partner organization, Research  Square. Reviewers with 
declared or apparent competing interests are not utilized for t hese reviews. This reviewer has 
agreed to publication of their comments online under a Creat ive Commons Attribution License 
attributed to Research Square and was paid a small honorarium for  completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer  
recommendation.  
 
I agree to the open peer  review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the author s' 
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 commen ts 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Hepatitis B virus -associated hepatocellular carcinoma in South Africa in the era of HIV  
 
Version: 3 Date: 21 Jan 2020  
 
Reviewer's report:  
 
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research 
question(s) (brief or other article types: is there a cle ar objective)?  
Yes - there is a clear objective  
 
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the 
objective?  
No - there are minor issues  
 
EXECUTION - Are the experiments and analyses performed with technical rigor to allow 
confidence in the results?  
No - there are minor issues  
 
STATISTICS - Is the use of statistics in the manuscript appropriate?  
Yes - appropriate statistical analyses have been used in the study  
 
INTERPRETATION - Is the current interpretation/d iscussion of the results reasonable and not 
overstated?  
No - there are minor issues  
 
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically 
sound? If not, can revisions be made to make the work technically sound?  
Probably - with min or revisions  
 
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS:  
The study was basically a repeat of earlier studies that investigated the relationship of HBV/HIV 
coinfection to the development of HCC (e.g., 10.1371/journal.pone.0196057; 10.1186/s12885 -
017-3915 -z).  There is nothing here that is really novel to report, and what was found is that co -
infection did not significantly change the survival of patients with HCC.  The only features that 
were novel was the relationship between HBV genotype A with HCC.  Thi s observation differed 
from that reported elsewhere (10.1016/j.bpg.2017.04.010), and it is not clear why these differ.  
The Discussion section brings up many topics in the paper which were not statistically different 
in the Results section, making this sec tion of the paper unusually long.  It is suggested that the 
Discussion focus upon the characteristics that are statistically different when single infections are 
compared to co -infections.  
 
REQUESTED REVISIONS:  
The authors do not really point out what the re is that is unique about their studies, and the 
Discussion is diffuse.  
ADDITIONAL REQUESTS/SUGGESTIONS:  
Seems like the major conclusion of the paper is that HIV co -infection really does not matter 
when it comes to survival of HBV/HIV co -infected patients.  
 
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 speci fy which controls are required in your comments to the authors.  
 
No 
 
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  
Pleas e indicate the quality of language in the manuscript:  
 
Acceptable  
 
 
 
 
 
 
 
 
 
 
 
 
 
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, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares  in an organisation t hat 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 recei ved 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.  
 
This reviewer has been recruited by a partner organization, Research  Square. Reviewers with 
declared or apparent competing interests are not utilized for t hese reviews. This reviewer has 
agreed to publication of their comments online under a Creat ive Commons Attribution License 
attributed to Research Square and was paid a small honorarium for  completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer  
recommendation.  
 
I agree to the open peer  review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the author s' 
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 commen ts 
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: Hepatitis B virus -associated hepatocellular carcinoma in South Africa in the era of HIV  
 
Version: 3 Date: 21 Jan 2020  
 
Reviewer's report:  
 
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research 
question(s) (brief or other article types: is there a cle ar objective)?  
Yes - there is a clear objective  
 
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the 
objective?  
No - there are minor issues  
 
EXECUTION - Are the experiments and analyses performed with technical rigor to allow 
confidence in the results?  
No - there are minor issues  
 
STATISTICS - Is the use of statistics in the manuscript appropriate?  
Yes - appropriate statistical analyses have been used in the study  
 
INTERPRETATION - Is the current interpretation/d iscussion of the results reasonable and not 
overstated?  
No - there are minor issues  
 
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically 
sound? If not, can revisions be made to make the work technically sound?  
Probably - with min or revisions  
 
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS:  
The study was basically a repeat of earlier studies that investigated the relationship of HBV/HIV 
coinfection to the development of HCC (e.g., 10.1371/journal.pone.0196057; 10.1186/s12885 -
017-3915 -z).  There is nothing here that is really novel to report, and what was found is that co -
infection did not significantly change the survival of patients with HCC.  The only features that 
were novel was the relationship between HBV genotype A with HCC.  Thi s observation differed 
from that reported elsewhere (10.1016/j.bpg.2017.04.010), and it is not clear why these differ.  
The Discussion section brings up many topics in the paper which were not statistically different 
in the Results section, making this sec tion of the paper unusually long.  It is suggested that the 
Discussion focus upon the characteristics that are statistically different when single infections are 
compared to co -infections.  
 
REQUESTED REVISIONS:  
The authors do not really point out what the re is that is unique about their studies, and the 
Discussion is diffuse.  
ADDITIONAL REQUESTS/SUGGESTIONS:  
Seems like the major conclusion of the paper is that HIV co -infection really does not matter 
when it comes to survival of HBV/HIV co -infected patients.  
 
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 speci fy which controls are required in your comments to the authors.  
 
No 
 
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  
Pleas e indicate the quality of language in the manuscript:  
 
Acceptable  
 
 
 
 
 
 
 
 
 
 
 
 
 
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, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares  in an organisation t hat 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 recei ved 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.  
 
This reviewer has been recruited by a partner organization, Research  Square. Reviewers with 
declared or apparent competing interests are not utilized for t hese reviews. This reviewer has 
agreed to publication of their comments online under a Creat ive Commons Attribution License 
attributed to Research Square and was paid a small honorarium for  completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer  
recommendation.  
 
I agree to the open peer  review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the author s' 
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 commen ts 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant