Liver metabolic health and the components of metabolic syndrome in people living with HIV - do they differ from those in a 'healthy' population?

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) has a greater prevalence in people living with human immunodeficiency virus (HIV) than in the general population. Reasons for this are connected with the presence of additional risk factors in people living with HIV, such as the infection itself with chronic immune system stimulation and HIV therapy adverse effects.

Objective: We aimed to compare metabolic syndrome components and MASLD-related parameters between people living with HIV on antiretroviral treatment at the clinic in Wroclaw and controls.

Methods: We conducted a case-control observational study on patients scheduled for visits from April to October 2021. We gathered blood samples and surveys from the patients and checked for metabolic and liver-related parameters.

Results: Sixty patients treated at an outpatient clinic in Wroclaw were enrolled into the study. Thirty controls were picked from healthy volunteers. People living with HIV had normal liver function parameters and HbA1c levels; they had a greater prevalence of dyslipidaemia (68.33% vs. 40%, p = 0.01), and higher homeostatic model assessment for insulin resistance (HOMA-IR) (2.16 vs. 1.24; p = 0.001). There was a difference between people living with HIV and controls in several MASLD-predictive models (FIB-4, NFS, NAFLD-LFS, Forns, TyG, MACK-3); however, it did not exceed the lower cut-off values for defining the risk of steatosis/fibrosis among people living with HIV.

Conclusions: We found people living with HIV to be more burdened by metabolic issues than our controls; however, people living with HIV did not appear to be more metabolically ill than the general Polish population.