Changes in Metabolic Profile in PLWHIV Switching to Doravirine-Based Regimen
, Rosa Anna Passerotto 1, Francesco Lamanna 1, Rebecca Jo Steiner 1, Francesca Lombardi 2, Pierluigi Francesco Salvo 1, Alex Dusina 2, Damiano Farinacci 3, Alberto Borghetti 2, Simona Di Giambenedetto 1,2 and Arturo Ciccullo 4Round 1
Reviewer 1 Report
In this study the authors aimed at assessing the impact of DOR-based 3-drug regimens on lipid profile in patients switching to this regimen.
The study included 38 patients, all treatment-experienced and virologically suppressed.
The authors compared metabolic parameters, namely low-density lipoprotein (LDL) value, total cholesterol and triglycerides, as well as the viral load and CD4+ cell count, between baseline and 48 weeks of follow up.
In general, the article contains data confirming previously obtained information about favorable metabolic profile DOR-containing regimens, leading to a significant reduction in total cholesterol. However, data obtained directly under clinical conditions, rather than in clinical trials, are important to practitioners and may be published.
The main drawback of the study is the small number of patients studied and relatively short time of follow-up.
Comments
1. The authors found the reduction in absolute CD4+ cell count at week 48. Although it is not very large, it would be good to try to comment on this fact.
2. The text of the article provides data on the reduction of parameters, but there are no data on absolute indicators at the beginning and end of the study. They must be entered in the table.
3. The English language needs some correction.
Author Response
Thank you for the advice, comments and revisions that have certainly improved the text.
I uploaded a Word-file, with point by point response.
Thank you in advice.
Author Response File: 
Author Response.pdf
Reviewer 2 Report
This manuscript examines the metabolic profile of drug-experienced PLWH subjected to a DOR-based therapy. Although this study is done in small sample size, the data strongly suggest that a DOR-based regimen has a favorable metabolic profile and in fact lowers total cholesterol within a year. These are interesting data because of the uniqueness of DOR, and since it is the latest FDA-approved NNRTI. This is a great start in examining the metabolic parameters of DOR, because of it does have a somewhat alternative resistance profile when compared rilpivirine and efavirenz. More comparative analyses would indeed improve the therapeutic regimens given to PLWH.
Some sentences need rewritten to make clear. I would make multiple sentences from long, compounded sentences found in the body of the manuscript.
17- antiretroviral (ARV)
20- delete “a” before long-term
21- add “The” before aim
23- people living with HIV (PLWH)
23- delete IV from PLWHIV and onward
51-52 rewrite sentence and remove barrier, there is no barrier that prevents the emergence of resistance
53- replace desumed with identified
68- add “The” in front of aim
71- replace switching to whom switched
78- replace comparison with comparative
118-119 rewrite sentence, make into 2 sentences. End the sentence after safety. Start new sentence with moreover.
128-130 rewrite sentence, make into 2 sentences.
132 replace “reduce” to “the reduction in”
133 replace factor with factors
133 move “also” in front of reduce
137 delete in individuals infected with HIV to PLWH
Author Response
Thanks for the advices about text structure and English grammar.
I uploaded the editing, point by point.
Thank you in advance.
Author Response File: Author Response.pdf
