Predicting MASLD in People With HIV Using Anthropometric Measures: A Multicenter Cross-Sectional Study

Area of Science:

• Hepatology
• Infectious Diseases (HIV/AIDS)
• Metabolic Disorders

Background:

• Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing concern in people with human immunodeficiency virus (PWH).
• Standard anthropometric measures like BMI and waist circumference (WC) are used for metabolic risk assessment, but their accuracy for MASLD in PWH is unclear.

Purpose of the Study:

• To evaluate the diagnostic performance of various anthropometric and metabolic indices for detecting hepatic steatosis in PWH.
• To compare the predictive accuracy of body mass index (BMI), WC, hip circumference, waist-to-hip ratio (WHR), and visceral adiposity index (VAI) for MASLD in this population.

Main Methods:

• A multicenter cross-sectional study involving 256 adults with HIV.
• Transient elastography with controlled attenuation parameter (CAP) was used to define hepatic steatosis (CAP ≥248 dB/m).
• Receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of different indices, stratified by sex.

Main Results:

• Waist circumference (WC) demonstrated the highest diagnostic discrimination for CAP-defined steatosis (AUC 0.769), outperforming BMI and hip circumference.
• WHR and VAI showed weaker performance in detecting hepatic steatosis.
• In sex-stratified analyses, WC was the best predictor in males, while BMI, WC, hip circumference, and VAI showed similar performance in females.

Conclusions:

• Simple anthropometric measures, especially WC, have fair ability to identify hepatic steatosis in PWH.
• WC can potentially facilitate targeted screening for fatty liver disease in PWH within routine HIV care settings.