Photo Credit: Mohammed Haneefa Nizamudeen

Weight gain, patient sex, and the presence of metabolic dysfunction-associated steatotic liver disease all influence fibrosis transitions in those with HIV.

Liver fibrosis among people with HIV is influenced by metabolic health regardless of ART type or coinfection with viral hepatitis, according to findings published in AIDS. Giovanni Guaraldi, MD, and colleagues examined the impact of weight gain and metabolic dysfunction-associated steatotic liver disease (MASLD) on liver fibrosis in HIV. The multicenter cohort study enrolled 1,183 people with HIV, a quarter of whom (25.2%) had viral hepatitis. Baseline prevalence of significant fibrosis and MASLD was 14.4% and 46.8%. Over a median follow-up of 2.5 years, the incidence rate of fibrosis progression and regression was 2.8 and 2.2 per 100 person-years. In Markov model, weight gain increased the odds of fibrosis progression (OR, 3.11; 95% CI, 1.59-6.08), while weight gain (OR, 0.30; 95% CI, 0.10-0.84) and being a man (OR, 0.32; 95% CI, 0.14-0.75) reduced the odds of fibrosis regression. In multivariable Cox regression analysis, predictors of fibrosis progression included weight gain (adjusted HR [aHR], 3.12; 95% CI, 1.41-6.90) and MASLD (aHR, 2.72; 95% CI, 1.05-7.02).