Metabolic dysfunction-associated steatotic liver disease in people with HIV.

Review article summarizing current state of science

“In this review, we summarize the current state of the science in MASLD-HIV and highlight areas in need of further investigation.”

People with HIV (PWH) with metabolic dysfunction-associated steatotic liver disease

“Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent among people with HIV (PWH) and increasingly recognized as a major contributor to morbidity and mortality.”

MASLD in PWH follows a more aggressive clinical course with faster fibrosis progression compared to the general population

“Compared to the general population, MASLD in PWH (MASLD-HIV) tends to present with more severe disease and a faster rate of progression.”

HIV-specific factors including altered body composition, chronic immune activation, and antiretroviral therapy exacerbate disease progression

“HIV-specific factors – including altered body composition, chronic immune activation, enhanced gut permeability, and antiretroviral therapy – exacerbate disease progression.”

A critical gap remains in evaluating MASLD interventions specifically among people with HIV

“Despite an expanding pipeline of MASLD therapies, a critical gap remains in evaluating these interventions specifically among PWH.”

People with HIV are often excluded from clinical trials of novel MASLD therapies

“Although an exciting array of new MASLD therapies is emerging, PWH are often excluded from MASLD clinical trials, which remains a barrier to the safe and effective implementation of novel therapies among this population.”