Metabolic dysfunction-associated steatotic liver disease and metabolic dysfunction-associated alcohol-related liver disease in human immunodeficiency virus

Table 1 Comparison of diagnostic criteria for nonalcoholic fatty liver disease, metabolic dysfunction-associated steatotic liver disease, metabolic dysfunction-associated alcoholic liver disease, and alcohol-associated liver disease

	NAFLD	MASLD	MetALD	ALD
Criteria	Hepatic steatosis ± metabolic dysfunction (not required)	Hepatic steatosis + metabolic dysfunction with ≥ 1 of following criteria: (1) BMI ≥ 25 kg/m2 or increased waist circumference (> 94 cm in men, > 80 cm in women); (2) HbA1c ≥ 5.7% or on diabetes medication(s); (3) Plasma triglycerides ≥ 150 mg/dL; (4) Low plasma HDL (< 40 mg/dL in men, < 50 mg/dL in women); and (5) Blood pressure ≥ 130/85 mmHg	Hepatic steatosis + alcohol consumption (above MASLD thresholds but below ALD thresholds) + metabolic dysfunction with ≥ 1 of following criteria: (1) BMI ≥ 25 kg/m2 or increased waist circumference (> 94 cm in men, > 80 cm in women); (2) HbA1c ≥ 5.7% or on diabetes medication(s); (3) Plasma triglycerides ≥ 150 mg/dL; (4) Low plasma HDL (< 40 mg/dL in men, < 50 mg/dL in women); and (5) Blood pressure ≥ 130/85 mmHg	Hepatic steatosis + alcohol consumption above MetALD thresholds ± metabolic dysfunction
Alcohol thresholds	Men: < 30 g/day; women: < 20 g/day	Men: < 30 g/day; women: < 20 g/day	Men: 30-60 g/day; women: 20-50 g/day	Men: > 60 g/day; women: > 50 g/day
Diagnostic approach	Exclusion-based	Inclusion-based	Inclusion-based	Alcohol-dominant

NAFLD: Non-alcoholic fatty liver disease; MASLD: Metabolic dysfunction-associated steatotic liver disease; BMI: Body mass index; HbA1c: Glycated hemoglobin; HDL: High-density lipoprotein; MetALD: Metabolic dysfunction-associated alcohol-related liver disease; ALD: Alcohol-associated liver disease.