Lipid Profile Differences in HIV-Infected Populations With Metabolic Dysfunction-Associated Steatotic Liver Disease:...

Advances in HIV management have transformed HIV into a chronic condition, resulting in improved prognosis and increased survival among people living with HIV (PLWH). Traditional risk factors for metabolic dysfunction-associated steatotic liver disease (MASLD)-including dyslipidemia-are prevalent in PLWH. This systematic review and meta-analysis aim to synthesize current evidence on lipid profile disturbances as contributors to MASLD in PLWH.

This systematic review and meta-analysis were conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in PROSPERO with registration number CRD420251054477. We searched seven databases to identify studies reporting the prevalence and characteristics of MASLD in PLWH. Meta-analysis was conducted using Review Manager 5.4.1. Mean differences (MDs) were calculated using a random-effects model. Risk of bias was assessed using the ROBINS-E tool.

A total of 17 studies comprising 3933 HIV-positive participants were included, among whom 1226 (37%) had MASLD. Male sex was significantly associated with MASLD (OR = 1.57; 95% CI: 1.13-2.17; p = 0.007). MASLD was significantly associated with higher body mass index (BMI) (MD = 3.23 kg/m²; p < 0.00001). Lipid profile analysis revealed that MASLD patients had higher total cholesterol (MD = 6.62 mg/dL; p = 0.01), low density lipoprotein (LDL) (MD = 3.83 mg/dL; p = 0.01), triglycerides (MD = 63.02 mg/dL; p < 0.00001), and lower high density lipoprotein (HDL) (MD = -3.73 mg/dL; p < 0.0001).

This study demonstrates a significant difference in lipid profiles (higher total cholesterol, LDL, triglycerides, and lower HDL) among PLWH who develop MASLD, suggesting a potential metabolic signature associated with this comorbidity.