Review for 10.1186/s12876-024-03456-9 (2024)

Title: Host cytokine genetic polymorphisms in a selected population of persons living with
hepatitis B virus infection in the Central Region of Ghana
Version: 2 Date: 22 Jul 2024
Reviewer:  Hussein Mukasa Kafeero
Reviewer's report:
The manuscript entitled “Host cytokine genetic polymorphisms in a selected population of
persons living with hepatitis B virus infection in the Central Region of Ghana” by Faustina Adu
et al., is not well written. There are several grammatical errors and typos. Besides, there is lack
coherence in the flow of the information.  These areas need to be addressed before acceptance for
publication in BMC Gastroenterology. However, it is one of the few studies among the African
Negros to address the issue of cytokine gene polymorphisms in the burden of HBV and the
authors should be commended for their work.
The authors therefore should address the following issues:
General comment
The authors have neither indicated line numbering nor page numbers. This makes referencing
during the review challenging. Please, the authors should amend the manuscript accordingly.
Abstract
1. The outcome of HBV infection is influenced by viral and hots factors including genetic. Check
the typo.
2.  “There 20–39-year-old group formed majority of the HBV infected participants with 60% of
all participants being classified as healthy HBsAg carriers” is not clear. Consider revising.
Introduction
3. Paragraph 4 should be merged with paragraph 1 since both are highlighting the prevalence
of HBV. Indeed, the authors have given a brief about the prevalence of HBV globally but they
salient when it comes to Africa, west Africa and Ghana. However, they eventually remember
Ghana in the last paragraph of the introduction. The reader loses the flow of the information.
4. Last paragraph has given the prevalence of HBV inn Ghana as referenced by 28 and 29. Both of
these are reviews. Can you provide concreate prevalence from health management information
systems (HMIS) or health surveys done in Ghana.
Methods
5. The authors have written “The study is a single-centre cross-sectional undertaken…” Is the
study ongoing or it has been completed? can you report
6. Sample size determination: why very few controls (20)? Were these ideal for comparisons?
Please clarify.
Results
7. Which test did the authors perform to generate the p values in tables 1- 3? It is not stated in
the methodology. Please clarify.
8. What is the purpose of table 5 in our understanding of the findings study? Can you provide
it as a supplementary material.
9. In table 6, what variable is the second column? It has been omitted
10. The authors talked about obtaining data on full blood count in the methodology section.
Where are the results of FBC in the results section? Please clarify
Discussion
11. The discussion should remain focused on the topic. Please consider removing the following
paragraphs under the discussion section;
a) The first paragraph. This has nothing to do with the topic. Besides, this information has been
given in the introduction section
b) The second paragraph. The gist of your study has nothing to do with demographic
characteristics. Giving a full paragraph under discussion is elusive. However, they can come in
if they influence the prevalence of the polymorphisms which is not plausible. Besides most of
the phrases in this paragraph appear to be part of the results presented.
c) The third paragraph. Your study had nothing to do with liver function tests or HBV DNA
levels. Discussing them in isolation is not required. They can only come if they are influenced
by the polymorphisms in the cytokine gene as discussed in paragraph 6.
d) The paragraph before the limitations should also be removed. It is not relevant in this study
as highlighted above
12. Indeed, your discussion should start with paragraph 3. However, the second in this
paragraph where the authors have written “Factors that influence hepatitis outcomes include
viral, environmental and host genetics”. Does this also include hepatic inflammation coming
from alcohol hepatitis, aflatoxin hepatitis and parasitic hepatitis? Please consider revising
Conclusions and recommendations
13. How do the results of your study fit into the strategy of eliminating HBV by 2030 as
highlighted in the SDGs?
14. What recommendations would you give to the Ghanaian government from your to guide the
fight against HBV?