PONE-D-24-28337Effects of nutritional interventions on nutritional and immunological status and adherence to antiretroviral treatment among adults living with HIV in low- and middle-income countries: Systematic Review and Meta-AnalysisPLOS ONE

Dear Dr. Nahaskida,

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Academic Editor

PLOS ONE

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Additional Editor Comments:

Please revise based on reviewers' comments.

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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

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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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: Yes

Reviewer #2: Yes

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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

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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: Line 138: what are controlled trials? arent they already included under RCTs?

Line 139: need to mention definition/criteria of LMIC used.

Line 143: What about studies which included both children and adults and also reported subgroup data for adults?

For PRISMA, the 2020 PRISMA figure for databases+other sources should be used.

Reviewer #2: Dear Editor,

I appreciate the opportunity to review the manuscript, "Effects of nutritional interventions on nutritional and immunological status and adherence to antiretroviral treatment among adults living with HIV in low- and middle-income countries: systematic review and meta-analysis." In addition to contributing to the worldwide literature and raising intriguing ideas, the article aids in the achievement of Sustainable Development Goal (SDG) goal 3.3, which calls for the eradication of the HIV epidemic by 2030.Before endorsing for publication, I have included some of my thoughts and recommendations that may strengthen the article.

Abstract

- Although the abstracts were written well, the authors should have included a few of the meta-analysis models and techniques they employed for evaluating the outcome variable.

- The study's focus is on low- and middle-income countries, but it's also important to see how many of these countries are included in the abstract (or results) section.

Introduction

-The introduction was well-written and presented; however, some of the lengthy statements needed to be supported by several citations (for e.g., lines 70-77).

Methods and Materials

- Why were pregnant and breastfeeding mothers or comorbidities excluded from the research population? Why were the authors unwilling to do sub-group analysis to determine the influence on policy? Were there any differences in the exclusion of those groups? The authors should have provided an explanation for their exclusion in the method section of their manuscript.

Result, discussion, and conclusion

- The results were well-written and narrated, and they discussed on the effect of nutritional interventions on PLWHA adherence to ART, food security, weight, BMI, body composition (including fat and fat-free mass), and MUAC. What about the findings that were made about particular countries? analysis of subgroups by gender or by country? Which countries or gender require more focus? What about gender-specific or country-specific policy implications? Are low-middle-income countries affected similarly by the findings? No environmental or geographic impact? or differences within health institutions? how the authors came up with those differences as their subject matter pertaining to LMICs.

- The recommendation is not feasible; who can benefit? low or middle-income countries?

Thanks

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Reviewer #1: No

Reviewer #2: No

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Effects of nutritional interventions on nutritional and immunological status and adherence to antiretroviral treatment among adults living with HIV in low- and middle-income countries: Systematic review and meta-analysis

PONE-D-24-28337R1

Dear Dr. Nahaskida,

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.

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Kind regards,

Anete Trajman

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

We thank the authors for revising the manuscript based on the reviewers' comments.

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 #2: All comments have been addressed

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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 #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: Yes

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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 #2: Yes

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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 #2: Yes

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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 #2: I appreciate the editor inviting me to review the manuscript again. I was grateful to the authors for their thoughtful revision and addressed all of my comments and recommendations. Lastly, in line with Sustainable Development Goal (SDG) 3.3, which calls for the eradication of the HIV pandemic by 2030, I will suggest the authors expand their discussion and offer suggestions for policymakers and healthcare professionals.

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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 #2: Yes:  Habtamu Endashaw Hareru

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