Fatty Liver Disease: Enter the Metabolic Era

Curr HIV/AIDS Rep. 2023 Dec;20(6):405-418. doi: 10.1007/s11904-023-00669-7. Epub 2023 Oct 26.

Abstract

Purpose of review: The goal of this review is to summarize the recent literature linking HIV to metabolic dysfunction-associated steatotic liver disease (MASLD). This is a pressing issue due to the scale of the MASLD epidemic and the urgent need for preventive and therapeutic strategies for MASLD in PWH.

Recent findings: The prevalence of MASLD in PWH is higher than previously appreciated, approaching 50% depending on the population and definition of MASLD. MASLD in PWH is likely multifactorial due to risk factors present in the general population such as metabolic syndrome, and features unique to HIV including systemic inflammation and ART. Statin therapy results in a significant reduction in major adverse cardiovascular events in PWH. PWH are at high risk for MASLD. Screening PWH with metabolic syndrome features could enable earlier interventions to reduce morbidity and mortality associated with MASLD in PWH.

Keywords: Cardiovascular disease; MASLD; Metabolic syndrome.

Publication types

  • Review

MeSH terms

  • Early Intervention, Educational
  • HIV Infections* / complications
  • HIV Infections* / drug therapy
  • Humans
  • Metabolic Syndrome* / complications
  • Non-alcoholic Fatty Liver Disease* / complications
  • Non-alcoholic Fatty Liver Disease* / epidemiology
  • Risk Factors