Baseline Liver Metabolic Health in Newly Diagnosed People Living with HIV Compared with HIV-Negative Controls: Cross-Sectional Findings from the Prospective MASHIV-TR Cohort
Çiğdem Mermutluoğlu, Yeşim Taşova, Ayşe Özlem Mete, İlkay Karaoğlan, Hüsnü Pullukçu, Meliha Çağla Sönmezer, Dilara İnan, Funda Şimşek, Sıla Akhan, Tuba Damar Çakırca, Nursel Çalık Başaran, Aslıhan Candevir, Yeliz Çiçek, Damla Ertürk, Ahmet Çağkan İnkaya, İsmail Yıldız, Behice Kurtaran, Müge Toygar Deniz, Yaşar Bayındır, Mustafa Kemal ÇelenMetabolic dysfunction-associated steatotic liver disease (MASLD) is an important comorbidity in people living with HIV (PLWH), yet most data derive from individuals receiving antiretroviral therapy (ART). In the baseline cross-sectional analysis of the prospective multicentre MASHIV-TR cohort (nine centres, Türkiye), we compared 250 newly diagnosed, ART-naïve PLWH and 161 HIV-negative controls. Hepatic steatosis and liver stiffness were assessed by vibration-controlled transient elastography; MASLD was defined as hepatic steatosis, indicated by CAP ≥ 248 dB/m together with at least one cardiometabolic risk factor. MASLD prevalence was similar in the two groups (25.2% vs. 30.4%; p = 0.245), and HIV status was not independently associated with MASLD. Triglyceride level was independently associated with CAP in PLWH (+10.69 dB/m per 50 mg/dL) and in controls (+9.26 dB/m), whereas CD4 and CD8 counts, the CD4/CD8 ratio and HIV-RNA were not associated with the liver outcomes. Before ART, hepatic steatosis tracked metabolic rather than HIV-specific markers.