Prevalence of Metabolic-Associated Steatotic Liver Disease in Patients with Type 2 Diabetes with and without HIV: Retrospective Multicenter Study

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a frequent complication in patients with Type 2 Diabetes (T2D). This study aims to evaluate the impact of HIV status on the prevalence of MASLD in patients with T2D. Methods: We utilized the TriNetX global federated health research network to perform a comparative analysis of two cohorts: T2D patients with HIV (Cohort 1) and T2D patients without HIV (Cohort 2). Propensity score matching controlled for confounders such as age, gender, Hemoglobin A1c, LDL, HDL, total cholesterol, triglycerides, BMI, and hypertension. The study was exempt from IRB review as it did not involve direct human subjects, per the University at Buffalo Institutional Review Board. Results: Initial data included 168,428 patients in Cohort 1 and 9,040,558 in Cohort 2. After matching, each cohort consisted of 166,803 patients. MASLD prevalence was 7.1% in HIV-positive T2D patients and 6.7% in HIV-negative T2D patients, with a significant risk difference (RD = 0.004, 95% CI: 0.002 to 0.006, p < 0.0001). The risk ratio (RR) was 1.062 (95% CI: 1.036 to 1.089), and the odds ratio (OR) was 1.067 (95% CI: 1.039 to 1.096). Conclusion: HIV-positive T2D patients exhibit a slightly higher risk of developing MASLD than their HIV-negative counterparts. These results underscore the need for specialized screening and management of MASLD in patients with T2D, particularly those living with HIV.