Abstract
ABSTRACT
Introduction
Liver steatosis is increasingly recognized as a major comorbidity in people living with HIV (PLWH), with growing evidence suggesting an increased risk of progression to advanced liver disease. We assessed predictors of liver steatosis progression over 36 months in PLWH from low‐ and middle‐income countries.
Methods
Between 2020 and 2023, we enrolled PLWH aged ≥40 years who had been on antiretroviral therapy (ART) for ≥6 months at nine HIV clinics in the IeDEA Sentinel Research Network (SRN) across the Asia‐Pacific, the Americas and African IeDEA regions, and followed them prospectively for 36 months. Participants with available and reliable controlled attenuation parameter (CAP) measurements at both enrolment and the 36‐month visits were included in the analysis. Steatosis progression was defined as incident steatosis (CAP ≥248 dB/m) or a transition to a higher steatosis grade (moderate ≥268 dB/m; severe ≥280 dB/m) among those with a lower steatosis grade at enrolment. Logistic regression was used to assess predictors of progression.
Results
We included 923 participants (63% female; median age 50 years, interquartile range 45–55) in this analysis. At enrolment, 51% were overweight or obese, 10% had type 2 diabetes mellitus (T2DM), 94% had HIV RNA
Conclusions
Metabolic disorders—including T2DM, overweight/obesity and dyslipidaemia—were associated with steatosis progression in PLWH in our cohort. These findings underscore the need for targeted monitoring and prevention strategies to address this significant public health issue.