MASLD in people with HIV exhibits higher fibrosis stage despite lower disease activity than in matched controls

Summary Background Metabolic dysfunction‐associated steatotic liver disease (MASLD) is common in people with HIV (PWH). The morphological spectrum of MASLD compared to matched controls and of the correlation between the NAFLD activity score (NAS) and fibrosis stage in PWH remains unknown. Methods Ov...

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Published in:Alimentary pharmacology & therapeutics 2024-11, Vol.60 (10), p.1351-1360
Main Authors: Allende, Daniela S., Cummings, Oscar, Sternberg, Alice L., Behling, Cynthia A., Carpenter, Danielle, Gill, Ryan M., Guy, Cynthia D., Yeh, Matthew M., Gawrieh, Samer, Sterling, Richard K., Naggie, Susanna, Loomba, Rohit, Price, Jennifer C., McLaughlin, Mary, Hadigan, Colleen, Crandall, Holly, Belt, Patricia, Wilson, Laura, Chalasani, Naga P., Kleiner, David E.
Format: Article
Language:English
Subjects:
Adult
Alanine transaminase
Biopsy
Body Mass Index
Case-Control Studies
Diabetes mellitus (non-insulin dependent)
Fatty Liver - complications
Fatty Liver - pathology
Female
Fibrosis
Hepatocytes
HIV
HIV Infections - complications
HIV Infections - pathology
Human immunodeficiency virus
Humans
Inflammation
Liver - pathology
Liver Cirrhosis - pathology
Liver diseases
Male
Middle Aged
Multivariate analysis
Non-alcoholic Fatty Liver Disease - complications
Non-alcoholic Fatty Liver Disease - pathology
Severity of Illness Index
Steatosis
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Summary:Summary Background Metabolic dysfunction‐associated steatotic liver disease (MASLD) is common in people with HIV (PWH). The morphological spectrum of MASLD compared to matched controls and of the correlation between the NAFLD activity score (NAS) and fibrosis stage in PWH remains unknown. Methods Overall, 107 liver biopsies from PWH with MASLD (MASLD‐PWH) were matched to 107 biopsies from individuals with MASLD and without HIV (MASLD controls) on age at biopsy, race/ethnicity, sex, type 2 diabetes, body mass index (BMI) and alanine aminotransferase (ALT) level. Biopsies were scored using NAS. Results Compared to MASLD‐controls, MASLD‐PWH had lower steatosis grade (OR: 0.65, 95% CI: (0.47–0.90), p = 0.01), lower lobular inflammation grade (OR: 0.55, 95% CI: (0.34–0.89), p = 0.02), less portal inflammation (OR: 0.42, 95% CI: (0.25–0.72), p = 0.002) and less ballooned hepatocytes (OR: 0.60, 95% CI: (0.41–0.88), p = 0.01). Thus, NAS was lower in MASLD‐PWH (OR: 0.69, 95% CI: (0.56–0.85), p 
ISSN:0269-2813
1365-2036
1365-2036
DOI:10.1111/apt.18236