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Referee Comments: Referee 2

Posted by PLOS_ONE_Group on 28 Apr 2008 at 18:11 GMT

Referee 2's Review:

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N.B. These are the comments made by the referee when reviewing an earlier version of this paper. Prior to publication the manuscript has been revised in light of these comments and to address other editorial requirements.
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Authors need to explicitly state that the current study is a sub-study of A5102 and is not analysed in accordance with the primary randomisation.

Through out the analysis it is unclear whether 'baseline' or the point of reference for changes is at randomization or at TI. This should be explicitly stated in the text and on the figures presented.

The time point at which changes from TI are reported varies between variables (2 weeks, 8 weeks, and 24 weeks). Was there an apriori reason for selecting these time points?

The 10 % difference in median increase in CD8+ T cells 8 weeks after TI between groups is regarded as similar, what was the p value. What were the CD8 counts for the two patient groups at the beginning of TI? The authors seem to assume that IL2 has no effect on CD8, the data should be provided to support this assumption.

Why was an HDL of <40mg/mL chosen as a category in the results? Further, in terms of discussion, what is the significance of the changes in metabolic indicators in terms of actual CDV risk.

Author's need to state what changes occurred in HIV plasma over 1st 18 weeks (whether or not there was any difference between arms) and following TI. There is a reference to return of detectable HIV plasma RNA, but no statement about the incidence or time taken to this event. HIV RNA results are of particular interest considering the authors' discussions about the relationship between HIV replication and inflammatory responses.

Further considering the discussion about ARVs and CDV risk it would be of interest to know the types of regimens patients were on at baseline and any changes to baseline ARVs during the course of the study.

Lastly the authors need to explicitly state the limitations of the study, particularly the small sample size, significant loss to follow up (as indicated on the figures) and exploratory nature of the study.