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TOPLINE
Most cases of steatotic liver disease (SLD) in women with HIV infection fall into the metabolic dysfunction-associated SLD (MASLD) category, and among women with SLD, HIV status was associated with higher odds of hepatic fibrosis, a pattern not seen in women without SLD.
METHODOLOGY
- Researchers conducted a cross-sectional analysis of 1580 women (1117 with HIV infection and 463 without; mean age, 50 years) from a US multicenter cohort to assess the prevalence of liver steatosis and severity of fibrosis among women with HIV infection and compare these findings with those among women without the infection.
- Vibration-controlled transient elastography was performed between 2013 and 2018 to identify SLD, defined as a controlled attenuation parameter of ≥ 248 dB/m, and clinically significant fibrosis, defined as liver stiffness of ≥ 7.1 kPa.
- Women with SLD were further classified as having MASLD or other subtypes as per the American Association for the Study of Liver Diseases algorithm.
- Various statistical models were used to study the association between HIV serostatus and fibrosis among women with SLD and those without the condition.
TAKEAWAY
- SLD was equally prevalent in women with HIV infection and those without the infection (47% in both groups; P = .95), and most cases (82%) were classified as MASLD.
- HIV infection was associated with 48% higher odds of clinically significant fibrosis (P = .04) in women with SLD but not in women without SLD.
- The combination of HIV and steatosis was associated with 51% higher odds of fibrosis (P < .01), with a significant interaction observed between HIV infection and SLD (P = .03).
- Among women with HIV infection, the odds of fibrosis in those with SLD increased in the presence of a detectable viral load (adjusted odds ratio, 2.41; P < .01).
IN PRACTICE
"[W]e found that most SLD observed in WWH [women with HIV] is due to MASLD, and HIV is associated with higher odds of fibrosis in women with SLD," the authors wrote.
SOURCE
The study was led by Maria J. Duarte, MD, MAS, University of California, San Francisco. It was published online on September 4, 2026, in JAIDS Journal of Acquired Immune Deficiency Syndromes.
LIMITATIONS
This study was cross-sectional in nature and thus did not allow conclusions about cause and effect. Steatosis and fibrosis were measured with elastography instead of liver biopsy; therefore, some results may have been miscategorized. Unmeasured factors, including past alcohol use and body fat distribution, potentially contributed to fibrosis and may have affected the results.
DISCLOSURES
The combined study cohort from which the participant population was drawn received funding from various sources. The authors reported no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
