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Diseases

Prevalence of Lean Metabolic Dysfunction-Associated Fatty Liver Disease in People Living with HIV

Strategic Insights

— 2 min read

Research conducted by Fudan University has investigated the prevalence of lean metabolic dysfunction-associated fatty liver disease (lean MAFLD) in people living with HIV (PLWH). The study aimed to evaluate the performance of ten diagnostic models in identifying MAFLD in this population. The results showed that lean MAFLD affected 58 (23.20%) of the 250 lean PLWH, with a prevalence of 39.06% in the overall population. Among the ten diagnostic models evaluated, the non-alcoholic fatty liver screening score (NSS) had the highest area under the receiver operating characteristic curve (AUROC) of 0.87, followed by the fatty liver index (FLI), ZJU index, and lipid accumulation product (LAP).

Key Takeaways:

  • The study found a significant prevalence of lean MAFLD among PLWH, with 39.06% of the overall population affected.
  • Lean MAFLD affected 23.20% of the lean PLWH, with the NSS having the highest AUROC of 0.87 among the diagnostic models evaluated.
  • The NSS performed significantly better than other diagnostic models, including VAI, SI, NAFLD-LFS, K-NAFLD, ION, and HSI.
  • The study highlights the need for specialized approaches to diagnose MAFLD in PLWH, as general population-based diagnostic models show moderate accuracy in diagnosing MAFLD in this subgroup.
  • The study was registered with the U.S. National Library of Medicine's ClinicalTrials.gov platform under the code NCT04215926 on December 29, 2019.
  • The research was funded by Shanghai Hospital Development Center, Shanghai's Three-year Action Plan For Strengthening Public Health System Construction, and Shanghai Municipal Science And Technology Major Project.
  • Presumably, this research suggests that healthcare providers should look beyond BMI when considering MAFLD in PLWH, as the condition can occur even in those with a normal weight.

Statistics:

  • 361 people living with HIV were included in the study, with 141 diagnosed with MAFLD.
  • 250 participants were classified as lean, with 58 (23.20%) diagnosed with MAFLD.
  • The prevalence of lean MAFLD among PLWH was 39.06%.
  • The ten diagnostic models evaluated had the following AUROCs:

+ NSS: 0.87

+ FLI: 0.86

+ ZJU: 0.85

+ LAP: 0.85

+ VAI: 0.80

+ SI: 0.80

+ NAFLD-LFS: 0.80

+ K-NAFLD: 0.79

+ ION: 0.79

+ HSI: 0.77

Sources:

  • Evaluation of ten diagnostic models for metabolic dysfunction-associated fatty liver disease in lean people living with HIV. BMC Infectious Diseases, 2025,25(1):1-10. (BMC Infectious Diseases - http://bmcinfectdis.biomedcentral.com)
  • NewsRx. Recent Studies from Fudan University Add New Data to HIV/AIDS (Evaluation of ten diagnostic models for metabolic dysfunction-associated fatty liver disease in lean people living with HIV). AIDS Weekly. October 13, 2025; p 110.

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