Seroprevalence of hepatitis E virus infection in the Americas: Estimates from a systematic review and meta-analysis

Nathalie Verónica Fernández Villalobos; Barbora Kessel; Isti Rodiah; Jördis Jennifer Ott; Berit Lange; Gérard Krause

doi:10.1371/journal.pone.0269253

Peer Review History

Original SubmissionMarch 4, 2022
4 Apr 2022 Decision Letter - Isabelle Chemin, Editor PONE-D-22-06563Seroprevalence of Hepatitis E Virus infection in the Americas: estimates from a systematic review and meta-analysisPLOS ONE Dear Dr. Fernández Villalobos, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the different points raised during the review process. Please submit your revised manuscript by 2 months. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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Currently, your Funding Statement reads as follows: "The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript." Please include your amended statements within your cover letter; we will change the online submission form on your behalf. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? 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PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Fernandez Villalobos et al. conducted a great and very interesting study on the seroprevalence, risk factors, transmission routes and genotypes of HEV in America. This manuscript is well written but there are a few points to review to improve the quality of the work. I therefore recommend it for publication after considering the following comments. Introduction L85-93: The review authors provide a wide summary of previous systematic reviews on the topic which is supported by Supplementary Table 2. With recent reviews having up to 68 studies (Horvaits, T et al 2018), 45 studies (Li, P et al 2020), and 42 studies (Wilhelm, B et al 2019) from America. However, the authors of this review were able to include up to 142 studies. This suggests different criteria for this review compared to previous ones. I suggest that the authors further strengthen rationale of this review by highlighting the specificities of their study on criteria such as the population, the diagnostic method, the research strategy, etc. Methodology I suggest authors to mention in the main manuscript the PRISMA checklist which was provided as a supplementary file. I suggest authors to hand-search for additional studies in the bibliography of previously published related reviews? I suggest that the authors specify the exclusion criteria. An outbreak investigation for example may be a case report, so it is good to clarify that case reports are excluded. I suggest adding a paragraph on reference management and study selection. L136: I suggest indicating how the two investigators who assessed the risk of bias proceeded to deal with disagreements. Results I suggest the authors to add a legend to explain the black and red text coding colors in Table 4 of the Supplementary Material. L272-274. I suggest indicating the figure that relates to these findings in the main manuscript. Reviewer #2: Abstract Background: 1. Please remove (Literature indicates sporadic evidence on HEV in the Americas). 2. Please remove (Our systematic review and meta-analysis). Methods: 1. Please remove (Our systematic review and meta-analysis (registration number in PROSPERO CRD42020173934) included peer-reviewed and published data on the seroprevalence of HEV in humans in the Americas). 2. Please add the names of the databases and the duration of the search. 3. Please add the complete name of the GLMM. Main text: 1. Some sentences need references. 2. The background is long, please short it. Method: 1. A bout publication bias, I find not a plan about it. I think, the authors do not have enough information about the publication bias. 2. The method section is weak. Some sentences repeated about meta-analysis. Discussion 1. The discussion of the article needs serious revisions. Findings should be emphasized in the discussion. Reviewer #3: This manuscript has well illustrated a scenario of hepatitis E virus infection in the Americas. I wonder whether the authors have identified and excluded the publications which might share some identical data, especially in different languages. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. 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Revision 1
28 Apr 2022 Author Response Reviewer #1 Fernandez Villalobos et al. conducted a great and very interesting study on the seroprevalence, risk factors, transmission routes and genotypes of HEV in America. This manuscript is well written but there are a few points to review to improve the quality of the work. I therefore recommend it for publication after considering the following comments. #1 - Introduction L85-93: The review authors provide a wide summary of previous systematic reviews on the topic which is supported by Supplementary Table 2. With recent reviews having up to 68 studies (Horvaits, T et al 2018), 45 studies (Li, P et al 2020), and 42 studies (Wilhelm, B et al 2019) from America. However, the authors of this review were able to include up to 142 studies. This suggests different criteria for this review compared to previous ones. I suggest that the authors further strengthen rationale of this review by highlighting the specificities of their study on criteria such as the population, the diagnostic method, the research strategy, etc. Response: We really appreciate this comment. We agreed with you because we were able to include further evidence in our study thanks to the search strategy and no language restriction. We have specified this in the introduction line 87. #2 - Methodology I suggest authors to mention in the main manuscript the PRISMA checklist which was provided as a supplementary file. Response: We have included this point in line 101. #3 - I suggest authors to hand-search for additional studies in the bibliography of previously published related reviews? Response: Thank you for this valuable comment. Indeed, during the search we applied the snowball method in the existing reviews to verify that we have included all the studies that were available. After corroborating this, we did not include any extra study, so we did not mention this in the manuscript. This is now corrected in line 104. #4 - I suggest that the authors specify the exclusion criteria. An outbreak investigation for example may be a case report, so it is good to clarify that case reports are excluded. Response: I apologize for this misunderstanding. In the qualitative review, we included all the evidence available, including outbreak investigation reports. For the quantitative analysis (meta-analysis), we excluded studies with low sample size (line 194) and one report with 100% of positive cases (line 362). #5 - I suggest adding a paragraph on reference management and study selection. Response: Thank you for the suggestion. We added this information now: line 106 and line 121 respectively. #6 - L136: I suggest indicating how the two investigators who assessed the risk of bias proceeded to deal with disagreements. Response: Thank you for this comment. We had a third reviewer available in case of disagreements; however, we solved the conflicts between the two investigators. Therefore, the third reviewer was not needed at the end. We have now specified this in line 142. Results #7 - I suggest the authors to add a legend to explain the black and red text coding colours in Table 4 of the Supplementary Material. Response: We apologize for this missing information and have included the legend on the respective table (S1 Table 4) #8 - L272-274. I suggest indicating the figure that relates to these findings in the main manuscript. Response: Thank you for your comment. However, we prefer not to focus on the presentation of overall pooled estimates since these are influenced by the composition of the studies, and as we have seen differing levels of seroprevalences in different subpopulations. For that reason, we focused on presenting the pooled estimates from the subgroup analysis. Reviewer #2 #1 - Abstract Background: 1. Please remove (Literature indicates sporadic evidence on HEV in the Americas). 2. Please remove (Our systematic review and meta-analysis). Response: Thank you for these observations. We agreed with these two points and deleted the content in line 25. #2 - Methods: 1. Please remove (Our systematic review and meta-analysis (registration number in PROSPERO CRD42020173934) included peer-reviewed and published data on the seroprevalence of HEV in humans in the Americas). 2. Please add the names of the databases and the duration of the search. 3. Please add the complete name of the GLMM. Response: Thank you for your comments. We have deleted the content in line 30, and included the names of the databases and date (line 29) and the name of the model (line 33). #3 - Main text: 1. Some sentences need references. 2. The background is long, please short it. Response: Thank you for these comments. We have strived to improve the quality of the text, accounting also for the comments from the other two reviewers (who requested adding some information). We also carefully checked that all statements in the text are appropriately referenced. Method: #4 - 1. A bout publication bias, I find not a plan about it. I think, the authors do not have enough information about the publication bias. Response: Thank you for your comment. We have improved the respective paragraph in the manuscript to make our point clearer in line 181. We have the understanding that the publication bias usually refers to a bias resulting from the fact that some studies are not published due to the direction and magnitude of their findings (i.e. because their results are not statistically significant). In our opinion, for seroprevalence studies, the statistical significance does not play a central role. We believe that the chance of not publishing the results because of a particular value of the seroprevalence found in the data is negligible. However, given the differences in seroprevalence in different subpopulations, our analysis is definitely affected by the choice of the populations to be studied. This can be influenced by convenience considerations, by funding incentives, by existing cohorts etc. We presented the composition of the populations as found in the publications in S1 Fig 2, and we comment on how this affects our results in the Discussion part of our paper (line 670). #5 - 2. The method section is weak. Some sentences repeated about meta-analysis. Response: We appreciate your comment and have now revised the text, tried to improve the flow, and avoid any repetitions without impairing the clarity and completeness of the description of our analyses. We hope to have amended the places you had found problematic. #6 - Discussion 1. The discussion of the article needs serious revisions. Findings should be emphasized in the discussion. Response: Thank you for your outlook. We critically revised the Discussion section, reordered, and reformulated some parts of it. We hope that the current text makes clearer our findings, their implications, their relationship with previous findings and limitations. Reviewer #3 This manuscript has well illustrated a scenario of hepatitis E virus infection in the Americas. I wonder whether the authors have identified and excluded the publications which might share some identical data, especially in different languages. Response: Thank you for this relevant comment. As we included articles in Spanish and English in the majority of cases, people can think about this problem. However, in this respect we did not find any exact translations or identical data between studies. Nevertheless, within one language we found several studies sharing the same samples as detailed in S1 Table 4. Here we always included only one representative in the quantitative analysis; the exclusions are specified in S1 Table 4 in red. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0269253.r002
18 May 2022 Decision Letter - Isabelle Chemin, Editor Seroprevalence of Hepatitis E Virus infection in the Americas: estimates from a systematic review and meta-analysis PONE-D-22-06563R1 Dear Dr. Fernández Villalobos, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Isabelle Chemin, PhD Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0269253.r003
Formally Accepted
20 May 2022 Acceptance Letter - Isabelle Chemin, Editor PONE-D-22-06563R1 Seroprevalence of Hepatitis E Virus infection in the Americas: estimates from a systematic review and meta-analysis Dear Dr. Fernández Villalobos: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Mrs Isabelle Chemin Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0269253.r004

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