High baseline body mass index predicts recovery of CD4+ T lymphocytes for HIV/AIDS patients receiving long-term antiviral therapy

Jiawen Zhu; Haimei Huang; Min Wang; Yun Zhang; Jinli Mo; Weiyi Tian; Sumin Tan; Li Jiang; Zhihao Meng; Shanfang Qin; Chuanyi Ning

doi:10.1371/journal.pone.0279731

Peer Review History

Original SubmissionJuly 22, 2022
12 Sep 2022 Decision Letter - Chika Kingsley Onwuamah, Editor PONE-D-22-20667High baseline body mass index predicts recovery of CD4+ T lymphocytes for HIV/AIDS patients receiving long-term antiviral therapyPLOS ONE Dear Dr. Ning, 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 points raised during the review process. The reviewers have made some comments and suggestions to improve the manuscript. Kindly consider all comments and revert with the revised manuscript timely. Please submit your revised manuscript by Oct 27 2022 11:59PM. 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. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Chika Kingsley Onwuamah, Ph.D. Academic Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. Thank you for stating in your Funding Statement: "This study received support from the National Natural Science Foundation of China (Grant Nos. 81803295 and 81760602), the Natural Science Foundation of Guangxi (2018GXNSFAA138031), the “Thirteenth Five-Year” National Major Science and Technology Projects (2018ZX10715008–002 and 2018ZX10302104–001), the Innovation Project of Guangxi Graduate Education (YCSW2021143), and the Opening topic fund of Guangxi Key Laboratory of AIDS Prevention and Treatment (No.gklapt 201902)." Please provide an amended statement that declares all the funding or sources of support (whether external or internal to your organization) received during this study, as detailed online in our guide for authors at http://journals.plos.org/plosone/s/submit-now. Please also include the statement “There was no additional external funding received for this study.” in your updated Funding Statement. Please include your amended Funding Statement within your cover letter. We will change the online submission form on your behalf. 3. Thank you for stating the following financial disclosure: "This study received support from the National Natural Science Foundation of China (Grant Nos. 81803295 and 81760602), the Natural Science Foundation of Guangxi (2018GXNSFAA138031), the “Thirteenth Five-Year” National Major Science and Technology Projects (2018ZX10715008–002 and 2018ZX10302104–001), the Innovation Project of Guangxi Graduate Education (YCSW2021143), and the Opening topic fund of Guangxi Key Laboratory of AIDS Prevention and Treatment (No.gklapt 201902)." Please state what role the funders took in the study. If the funders had no role, please state: ""The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."" If this statement is not correct you must amend it as needed. Please include this amended Role of Funder statement in your cover letter; we will change the online submission form on your behalf. 4. Your ethics statement should only appear in the Methods section of your manuscript. If your ethics statement is written in any section besides the Methods, please move it to the Methods section and delete it from any other section. Please ensure that your ethics statement is included in your manuscript, as the ethics statement entered into the online submission form will not be published alongside your manuscript. 5. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. [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 ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: No Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? 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 ****** 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: Have the authors made all data underlying the findings in their manuscript fully available? The results state that Most patient were followed for ≤8 years. Furthermore, the authors also present that CD4+ T cells continued to increase with the length of follow-up. The authors however did not present results from the follow up after 8 years in the univariate and multivariate regression models even though this was used for the Kaplan Meier curves. it would be important to review which variables remained statistically significant across 1, 3, 5 and also 8 years of follow up. Reviewer #2: REVIEW FOR MANUSCRIPT TITLED “HIGH BASELINE BODY MASS INDEX PREDICTS RECOVERY OF CD4+ T LYMPHOCYTES FOR HIV/AIDS PATIENTS RECEIVING LONG-TERM ANTIVIRAL THERAPY” In this manuscript, the authors performed a database review of HIV-positive individuals to ascertain the relationship between baseline BMI and CD4 T cell count recovery in patients who are receiving ARVs for a period of 17 years. The long duration of the review provided a robust database to obtain data. This is a favorable aspect of the study. The statistical input was quite detailed. The findings from the work tend to suggest a direct relationship between CD4 T cell count and BMI ie patients with higher BMI tend to have better recovery of CD4+ lymphocytes Findings from this work will influence key aspects of clinical decision-making in the care and management of patients living with HIV However, the authors should provide clarity on the following aspects: 1. The author should distinguish between patients who have developed AIDs based on Clinical and laboratory criteria and those who are HIV positive. 2. There should be a statistical sub-analysis based upon this classification. This will help to put findings from the study in a proper perspective. For instance, it should be clear from the analysis if the recovery of CD4 T cells and T lymphocytes is better in patients WITHOUT AIDs defining symptoms versus patients WITH AIDs defining symptoms. ****** 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. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Obiageli Onwusaka Reviewer #2: Yes: OHIHOIN AIGBE GREGORY ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0279731.r001
Revision 1
25 Oct 2022 Author Response Article Title: High baseline body mass index predicts recovery of CD4+ T lymphocytes for HIV/AIDS patients receiving long-term antiviral therapy Dear editors and reviewers, Thank you for your further feedback. Please see below for our responses to your comments and concerns, listed in their original order of appearance; your comments are shown in bold, while our responses are shown in regular font type. As per before, if you have any further questions, please do not hesitate to let us know. Sincerely, Chuanyi Ning Editor’s comments: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf Response: Thank you for the comment. We have double checked and modified the format of the manuscript as required. 2. Thank you for stating in your Funding Statement: "This study received support from the National Natural Science Foundation of China (Grant Nos. 81803295 and 81760602), the Natural Science Foundation of Guangxi (2018GXNSFAA138031), the “Thirteenth Five-Year” National Major Science and Technology Projects (2018ZX10715008–002 and 2018ZX10302104–001), the Innovation Project of Guangxi Graduate Education (YCSW2021143), and the Opening topic fund of Guangxi Key Laboratory of AIDS Prevention and Treatment (No.gklapt 201902)." Please provide an amended statement that declares all the funding or sources of support (whether external or internal to your organization) received during this study, as detailed online in our guide for authors at http://journals.plos.org/plosone/s/submit-now. Please also include the statement “There was no additional external funding received for this study.” in your updated Funding Statement. Please include your amended Funding Statement within your cover letter. We will change the online submission form on your behalf. Response: Thank you for the critique. We have included the funding statement in the cover letter, as well as the updated manuscript. 3. Thank you for stating the following financial disclosure: "This study received support from the National Natural Science Foundation of China (Grant Nos. 81803295 and 81760602), the Natural Science Foundation of Guangxi (2018GXNSFAA138031), the “Thirteenth Five-Year” National Major Science and Technology Projects (2018ZX10715008–002 and 2018ZX10302104–001), the Innovation Project of Guangxi Graduate Education (YCSW2021143), and the Opening topic fund of Guangxi Key Laboratory of AIDS Prevention and Treatment (No.gklapt 201902)." Please state what role the funders took in the study. If the funders had no role, please state: ""The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."" If this statement is not correct you must amend it as needed. Please include this amended Role of Funder statement in your cover letter; we will change the online submission form on your behalf. Response: Thank you for the critique. We have included the Role of Funder statement in the cover letter, as well as the updated manuscript. 4. Your ethics statement should only appear in the Methods section of your manuscript. If your ethics statement is written in any section besides the Methods, please move it to the Methods section and delete it from any other section. Please ensure that your ethics statement is included in your manuscript, as the ethics statement entered into the online submission form will not be published alongside your manuscript. Response: Thank you for the critique. We have moved the ethical statement to the Methods section. 5. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Response: Thank you for the critique. We have replaced the incorrect reference in the revised version. Please let us know if you still have any question. The details are as follows: Original citation: [7]STD and AIDS Prevention and Control Center CCfDCaP. National Free HIV Antiretroviral Drug Treatment Handbook (4th Edition): People's Medical Publishing House; 2016. Replaced Citation: [7][Chinese guidelines for diagnosis and treatment of HIV/AIDS (2018)]. Zhonghua nei ke za zhi. 2018;57(12):867-84. Reviewers’ comments: Reviewer #1: Have the authors made all data underlying the findings in their manuscript fully available? Response: Thank you for the critique. Many thanks to the editor for your efforts to this manuscript. We have the right to access the raw data and no administrative permissions is required. But the raw data is not publicly available because of ethical and legal reasons. The results state that Most patient were followed for ≤8 years. Furthermore, the authors also present that CD4+ T cells continued to increase with the length of follow-up. The authors however did not present results from the follow up after 8 years in the univariate and multivariate regression models even though this was used for the Kaplan Meier curves. it would be important to review which variables remained statistically significant across 1, 3, 5 and also 8 years of follow up. Response: Thank you for the critique. Most patients were followed up for ≤8 years, 114 patients (about 1.9%) were followed up for more than 8 years, and only 79 patients were able to calculate the change of CD4 lymphocyte count. In order to avoid the low efficiency of statistical test, our analysis data were not included in the patients who had been followed up for more than 8 years. Therefore, we supplemented the 8-year follow-up data to the updated table 2 according your suggestions. The data showed that age, the occurrence of virologic failure, and sex were related to the change in CD4+ T cells during the 1st, 3rd, 5th and 8th years of follow-up. Taking the fifth year as an example, older age [-3.36 (-4.06, -2.65), P<0.001] and the occurrence of virologic failure [-115.81 (-150.32, -81.29), P<0.001] were negative factors for CD4+ T-cell gain. CD4+ T-cell concentration was significantly increased in females compared with males [48.28 (30.15, 66.41), P<0.001]. Reviewer #2: REVIEW FOR MANUSCRIPT TITLED “HIGH BASELINE BODY MASS INDEX PREDICTS RECOVERY OF CD4+ T LYMPHOCYTES FOR HIV/AIDS PATIENTS RECEIVING LONG-TERM ANTIVIRAL THERAPY” In this manuscript, the authors performed a database review of HIV-positive individuals to ascertain the relationship between baseline BMI and CD4 T cell count recovery in patients who are receiving ARVs for a period of 17 years. The long duration of the review provided a robust database to obtain data. This is a favorable aspect of the study. The statistical input was quite detailed. The findings from the work tend to suggest a direct relationship between CD4 T cell count and BMI ie patients with higher BMI tend to have better recovery of CD4+ lymphocytes Findings from this work will influence key aspects of clinical decision-making in the care and management of patients living with HIV However, the authors should provide clarity on the following aspects: 1. The author should distinguish between patients who have developed AIDs based on Clinical and laboratory criteria and those who are HIV positive. Response: Thank you very much for pointing this out. We have added the analysis to compare the CD4 changes between the HIV positive, AIDS with AIDS defining symptoms and AIDS without AIDS defining symptoms according your comment #1 and comment #2. The data analysis results showed that there was no correlation between each group for CD4 changes, and the difference was not statistically significant. We added these results in the supplementary materials, please see the Table S1. Please let us know if you still have question. Table S1. Univariate and Multivariate Analysis of CD4 Change of HIV Positive and AIDS with or without Symptoms 2.There should be a statistical sub-analysis based upon this classification. This will help to put findings from the study in a proper perspective. For instance, it should be clear from the analysis if the recovery of CD4 T cells and T lymphocytes is better in patients WITHOUT AIDs defining symptoms versus patients WITH AIDs defining symptoms. Response: Thank you very much for your comments. As mentioned above, please see the Table S1 above. We selected patients defined as AIDS, and divided them into two groups according to whether they have AIDS defining symptoms or not. We used a linear regression model to analyze and compare the changes of CD4 in patients without AIDS defining symptoms versus patients with AIDS defining symptoms. Results also shown that there was no statistical difference between these two groups. Please see more details in the Table S1. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0279731.r002
8 Dec 2022 Decision Letter - Chika Kingsley Onwuamah, Editor PONE-D-22-20667R1High baseline body mass index predicts recovery of CD4+ T lymphocytes for HIV/AIDS patients receiving long-term antiviral therapyPLOS ONE Dear Dr. Ning, 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 points raised during the review process. Please see below the few issues raised by the reviewers and kindly address them point-by-point. Please submit your revised manuscript by Jan 22 2023 11:59PM. 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. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Chika Kingsley Onwuamah, Ph.D. Academic Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed Reviewer #2: All comments have been addressed ******** 2. 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 ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? 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 ****** 6. 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: (No Response) Reviewer #2: REVIEW FOR MANUSCRIPT TITLED “HIGH BASELINE BODY MASS INDEX PREDICTS RECOVERY OF CD4+ T LYMPHOCYTES FOR HIV/AIDS PATIENTS RECEIVING LONG-TERM ANTIVIRAL THERAPY” In this manuscript, the authors performed a database review of HIV-positive individuals to ascertain the relationship between baseline BMI and CD4 T cell count recovery in patients who are receiving ARVs for a period of 17 years. The long duration of the review provided a robust database to obtain data. This is a favorable aspect of the study. The statistical input was quite detailed. The findings from the work tend to suggest a direct relationship between CD4 T cell count and BMI ie patients with higher BMI tend to have better recovery of CD4+ lymphocytes Findings from this work will influence key aspects of clinical decision-making in the care and management of patients living with HIV However, the authors should provide clarity on the following aspects: 1. The author should distinguish between patients who have developed AIDs based on Clinical and laboratory criteria and those who are HIV positive. 2. There should be a statistical sub-analysis based upon this classification. This will help to put findings from the study in a proper perspective. For instance, it should be clear from the analysis if the recovery of CD4 T cells and T lymphocytes is better in patients WITHOUT AIDs defining symptoms versus patients WITH AIDs defining symptoms. UPDATE ON REVIEW The authors have responded appropriately to my earlier comments above. ****** 7. 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. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Obiageli Chiezey Onwusaka Reviewer #2: Yes: OHIHOIN AIGBE GREGORY ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0279731.r003
Revision 2
12 Dec 2022 Author Response Article Title: High baseline body mass index predicts recovery of CD4+ T lymphocytes for HIV/AIDS patients receiving long-term antiviral therapy Dear editors and reviewers, Thank you for your further feedback. Please see below for our responses to your comments and concerns, listed in their original order of appearance; your comments are shown in bold, while our responses are shown in regular font type. As per before, if you have any further questions, please do not hesitate to let us know. Sincerely, Chuanyi Ning Editor’s comments: Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Response: Thank you for the critique. We have updated the reference style in the revised edition and replaced the incorrect reference. Please let us know if you still have any question. The details are as follows: Original citation: [34]Sørensen TI, Echwald S, Holm JC. Leptin in obesity. BMJ (Clinical research ed). 1996;313(7063):953-4. Replaced Citation: [34]Zimmet P, Hodge A, Nicolson M, Staten M, de Courten M, Moore J, et al. Serum leptin concentration, obesity, and insulin resistance in Western Samoans: cross sectional study. BMJ (Clinical research ed). 1996;313(7063):965-9. Epub 1996/10/19. doi: 10.1136/bmj.313.7063.965. PubMed PMID: 8892415; PubMed Central PMCID: PMCPMC2352310. We have fully dealt with the comments of the two reviewers in the last round of review and have been recognized by the two reviewers. Here we have updated the references and hope to get your reply. Attachments Attachment Submitted filename: Response to Reviewers - new.docx https://doi.org/10.1371/journal.pone.0279731.r004
14 Dec 2022 Decision Letter - Chika Kingsley Onwuamah, Editor High baseline body mass index predicts recovery of CD4+ T lymphocytes for HIV/AIDS patients receiving long-term antiviral therapy PONE-D-22-20667R2 Dear Dr. Ning, 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, Chika Kingsley Onwuamah, Ph.D. Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0279731.r005
Formally Accepted
19 Dec 2022 Acceptance Letter - Chika Kingsley Onwuamah, Editor PONE-D-22-20667R2 High baseline body mass index predicts recovery of CD4+ T lymphocytes for HIV/AIDS patients receiving long-term antiviral therapy Dear Dr. Ning: 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 Dr. Chika Kingsley Onwuamah Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0279731.r006

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