TY  - JOUR
VL  - 25
SP  - 1259
IS  - 11
N1  - © 2024 The Author(s). HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.


This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
UR  - https://doi.org/10.1111/hiv.13697
SN  - 1464-2662
JF  - HIV Medicine
A1  - Kablawi, Dana
A1  - Milic, Jovana
A1  - Thomas, Tyler
A1  - Tadjo, Thierry Fotsing
A1  - Cinque, Felice
A1  - Elgretli, Wesal
A1  - Gioe, Claudia
A1  - Lebouche, Bertrand
A1  - Tsochatzis, Emmanuel
A1  - Finkel, Jemima
A1  - Bhagani, Sanjay
A1  - Cascio, Antonio
A1  - Guaraldi, Giovanni
A1  - Mazzola, Giovanni
A1  - Saeed, Sahar
A1  - Sebastiani, Giada
TI  - Metabolic dysfunction-associated steatohepatitis exhibits sex differences in people with HIV
AV  - public
Y1  - 2024/11//
EP  - 1269
N2  - OBJECTIVES: 
People with HIV are at increased risk for metabolic dysfunction-associated steatohepatitis (MASH). Although sex differences are documented in the general population, their role in the context of HIV is less understood.


METHODS: 
This was a multicentre cohort study including people with HIV without viral hepatitis coinfection. A FibroScan-AST (FAST) score?>0.35 was used to diagnose MASH with significant liver fibrosis (stage F2?F4). We investigated sex-based differences in MASH trends as a function of age using a segmented linear mixed-effects model. Random effects accounted for clustering by the four sites. Adjusted models included ethnicity, diabetes, hypertension, and detectable HIV viral load.

RESULTS: 
We included 1472 people with HIV (25% women). At baseline, the prevalence of MASH with fibrosis by FAST score was lower in women than in men (4.8% vs. 9.2%, p?=?0.008). Based on the adjusted model, male sex (+0.034; p?=?0.04), age per year (+0.003; p?=?0.05), detectable HIV viral load (+0.034; p?=?0.02), and hypertension (+0.03; p?=?0.01) were positively associated with MASH with fibrosis. Although men exhibited generally higher FAST scores, FAST scores increased in women during the critical biological age of presumed perimenopause to menopause (between 40 and 50?years), reaching levels similar to those in men by the age of 55?years.

CONCLUSION: 
Despite women with HIV having a lower prevalence of MASH with fibrosis than men, they exhibit an acceleration in FAST score increase around the perimenopausal age. Future studies should target adequate consideration of sex differences in clinical investigation of metabolic dysfunction-associated steatotic liver disease to fill current gaps and implement precision medicine for people with HIV.
ID  - discovery10204497
PB  - WILEY
KW  - FAST score
KW  -  liver fibrosis
KW  -  MASLD
KW  -  perimenopause
KW  -  sexual hormones
KW  -  transient elastography
ER  -