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

Table 2 Epidemiology of metabolic dysfunction-associated steatotic liver disease and metabolic dysfunction-associated alcohol-related liver disease in people living with human immunodeficiency virus

Study	Study design	Steatosis/MASLD prevalence	MetALD prevalence	Fibrosis/key outcomes	Key epidemiologic insights
Gawrieh et al[21]	Cross-sectional; n = 1065 PLWH	SLD 52%; MASLD 38%	Approximately 10%	15% with clinically significant fibrosis	MASLD is dominant liver disease; obesity and ALT/AST are strongest predictors
Guaraldi et al[26]	Observational cohort; HIV mono-infected	Approximately 37% hepatic steatosis	Not assessed	Fibrosis risk increased with ART duration	11% increased odds of MASLD per year of NRTI exposure
Ram et al[23]	Single-center pilot study	MASLD 41%; 16.6% after excluding obesity/T2DM	Not assessed	> 28% with advanced fibrosis	HIV may contribute independently to MASLD and fibrosis
Lyu et al[31]	Observational cohort	Not primary outcome	Not assessed	Higher odds of fibrosis with alcohol consumption > 50 g/day	Alcohol synergizes with metabolic dysfunction in PLWH
Wong et al[27]	Retrospective cohort	MASLD prevalent in all subjects	Not assessed	Higher MACE rates in PLWH with MASLD	MASLD in PLWH confers excess cardiovascular risk

PLHW: People living with human immunodeficiency virus; HIV: Human immunodeficiency virus; MASLD: Metabolic dysfunction-associated steatotic liver disease; SLD: Steatotic liver disease; T2DM: Type 2 diabetes mellitus; MetALD: Metabolic dysfunction-associated alcohol-related liver disease; ART: Antiretroviral therapy; MACE: Major adverse cardiovascular events; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; NRTI: Nucleoside reverse transcriptase inhibitor.