eprintid: 10204497 rev_number: 7 eprint_status: archive userid: 699 dir: disk0/10/20/44/97 datestamp: 2025-02-11 12:07:40 lastmod: 2025-02-11 12:07:40 status_changed: 2025-02-11 12:07:40 type: article metadata_visibility: show sword_depositor: 699 creators_name: Kablawi, Dana creators_name: Milic, Jovana creators_name: Thomas, Tyler creators_name: Tadjo, Thierry Fotsing creators_name: Cinque, Felice creators_name: Elgretli, Wesal creators_name: Gioe, Claudia creators_name: Lebouche, Bertrand creators_name: Tsochatzis, Emmanuel creators_name: Finkel, Jemima creators_name: Bhagani, Sanjay creators_name: Cascio, Antonio creators_name: Guaraldi, Giovanni creators_name: Mazzola, Giovanni creators_name: Saeed, Sahar creators_name: Sebastiani, Giada title: Metabolic dysfunction-associated steatohepatitis exhibits sex differences in people with HIV ispublished: pub divisions: UCL divisions: B02 divisions: C10 divisions: D15 divisions: D17 divisions: G91 keywords: FAST score, liver fibrosis, MASLD, perimenopause, sexual hormones, transient elastography note: © 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. abstract: 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. date: 2024-11 date_type: published publisher: WILEY official_url: https://doi.org/10.1111/hiv.13697 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 2303173 doi: 10.1111/hiv.13697 medium: Print-Electronic lyricists_name: Tsochatzis, Emmanouil lyricists_name: Bhagani, Sanjay lyricists_id: ETSOC40 lyricists_id: BHAGA72 actors_name: Tsochatzis, Emmanouil actors_id: ETSOC40 actors_role: owner funding_acknowledgements: [Canadian Network on Hepatitis C (CanHepC)]; [Public Health Agency of Canada]; 311200 [Fonds de Recherche du Quebec-Sante (FRQS)]; [Quebec Ministry of Health]; 296306 [FRQS] full_text_status: public publication: HIV Medicine volume: 25 number: 11 pagerange: 1259-1269 pages: 11 event_location: England issn: 1464-2662 citation: Kablawi, Dana; Milic, Jovana; Thomas, Tyler; Tadjo, Thierry Fotsing; Cinque, Felice; Elgretli, Wesal; Gioe, Claudia; ... Sebastiani, Giada; + view all <#> Kablawi, Dana; Milic, Jovana; Thomas, Tyler; Tadjo, Thierry Fotsing; Cinque, Felice; Elgretli, Wesal; Gioe, Claudia; Lebouche, Bertrand; Tsochatzis, Emmanuel; Finkel, Jemima; Bhagani, Sanjay; Cascio, Antonio; Guaraldi, Giovanni; Mazzola, Giovanni; Saeed, Sahar; Sebastiani, Giada; - view fewer <#> (2024) Metabolic dysfunction-associated steatohepatitis exhibits sex differences in people with HIV. HIV Medicine , 25 (11) pp. 1259-1269. 10.1111/hiv.13697 <https://doi.org/10.1111/hiv.13697>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10204497/1/HIV%20Medicine%20-%202024%20-%20Kablawi%20-%20Metabolic%20dysfunction%25E2%2580%2590associated%20steatohepatitis%20exhibits%20sex%20differences%20in%20people%20with.pdf