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Metabolic Dysfunction–Associated Steatotic Liver Disease Is Associated With Impaired Health-Related Quality of Life in People With HIV

Year: 2026

Type: article

Abstract: Background and Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) is common in people with HIV (PWH), yet its impact on health-related quality of life (HRQoL) remains poorly characterized. We evaluated the association between MASLD and both generic and liver-specific HRQoL. Methods: We conducted a cross-sectional analysis within a national multicenter cohort of PWH. MASLD was defined as hepatic steatosis (controlled attenuation parameter >248 dB/m) plus at least metabolic comorbidity and significant liver fibrosis as liver stiffness measurement ≥8 kPa on FibroScan. Generic HRQoL was assessed using the Short Form-36 and liver-specific HRQoL using the Chronic Liver Disease Questionnaire (CLDQ). Adjusted estimated mean differences were estimated using multivariable linear regression. Results: Among 519 participants, the prevalence of MASLD and significant liver fibrosis was 41.4% and 7.2%, respectively. MASLD was independently associated with lower generic HRQoL, including reduction of physical functioning (-4.6; 95% confidence interval [CI] -9.12 to -0.01) and general health (-4.5; 95% CI -8.58 to -0.48) on the Short Form-36. Liver-specific HRQoL was more affected; MASLD was associated with a lower overall CLDQ score (-0.29; 95% CI -0.49 to -0.09), driven by worse fatigue, systemic symptoms, emotional symptoms, and worry. Among PWH with MASLD, increasing metabolic comorbidity burden was associated with a dose-response decline in physical HRQoL, whereas liver-specific HRQoL did not differ across comorbidity strata. Significant fibrosis was associated with lower CLDQ activity (-0.62; 95% CI -1.20 to -0.05) and worry (-0.60; 95% CI -1.15 to -0.05). Conclusion: In PWH, MASLD is associated with impaired HRQoL, particularly fatigue, systemic symptoms, and emotional well-being. Greater metabolic burden and liver fibrosis further worsen patient-reported outcomes.

Source: Gastro Hep Advances

DOI: 10.1016/j.gastha.2026.100966