Review of: "Prevalence and Factors Associated with Non-communicable Diseases Among People Living with HIV at Kalisizo Hospital in Kyotera District, Uganda: A Cross-Sectional Study"

Major Issues Requiring Revision 1. Limited generalizability and single-center designThe study population was drawn from a single hospital HIV clinic, which may introduce selection bias and limit external validity. Suggested improvementProvide discussion on how clinic-attending PLHIV may differ from community-based populations.Clarify referral patterns and whether patients with advanced disease stages are overrepresented. Cross-sectional design limits causal interpretationAlthough acknowledged in the limitations, several sections of the discussion imply causal relationships. Suggested improvementReplace causal wording with associative language.Emphasize temporal ambiguity between ART exposure, lifestyle risk factors, and NCD development. Potential residual confounding from ART-related variablesImportant HIV-related factors in uencing NCD development were not fully explored.