{
  "abstract": "Background Given the growing survival of liver transplant (LT) recipients, non graft-related complications have emerged as major determinants of morbidity. Data on post-transplant comorbidities in LT recipients with HIV infection remain limited, particularly regarding metabolic complications and metabolic dysfunction–associated steatotic liver disease (MASLD).Methods This retrospective, propensity score–matched (1:3) case–control study included 87 LT recipients with HIV and 261 without HIV transplanted at the University Hospital of Modena between 2003 and 2024. Matching variables were age, sex, MELD score, hepatocellular carcinoma (HCC), HBV/HCV co-infection, and donor age. Prevalence at LT and incidence rates (IR) post-LT of arterial hypertension, diabetes, dyslipidemia, cardiovascular events (CVE) and MASLD were assessed. MASLD was defined as hepatic steatosis, detected by imaging or histology, in association with at least one cardiometabolic risk factor among overweight/obesity, diabetes, hypertension, dyslipidemia, or insulin resistance.Results Of 348 recipients, 17% were females, with median age of 53 years (IQR 47-58) ( table 1). Main indications to transplantation were described in figure 1. MASLD-related cirrhosis was the main indication to LT in 4.6% HIV and 5.4% non-HIV recipients (p=0.780), whereas alcohol-related cirrhosis was reported in 13.8% HIV and 23% non-HIV recipients (p=0.067). At LT, hypertension and dyslipidemia were more prevalent in HIV recipients than non-HIV (38% vs 18% and 26% vs 6%, p<0.05), while diabetes prevalence was comparable (21% vs 18%, p=0.371). Post-LT dyslipidemia occurred more frequently in HIV recipients [58% vs 35%; IR 1.8 (95%CI 1.3-2.5) vs 0.5 (95% CI 0.4-0.6) per 100PYFU], whereas incidence rates of hypertension and CVE were similar. New-onset diabetes occurred in 15% of HIV and 25% of non-HIV recipients (p=0.052) with IR 0.2 (95%CI 0.1-0.4) vs 0.3 (95%CI 0.2-0.4) per 100PYFU (figure 2a-c). Post-LT overweight/obesity developed in 17% of HIV and 32% of non-HIV recipients (p=0.053).Post-LT MASLD was diagnosed in 19.2% of recipients, with similar IR between groups: 3.1 (95%CI 1.9–5.3) in HIV vs 3.2 (95%CI 2.5–4.2) in non-HIV per 100PYFU (p=0.947) (figure 2d). However, a hepatic steatosis index >36 was more frequent in non-HIV recipients (31% vs 21%, p=0.038). Post-LT MASLD was not associated with increased risk of HCC recurrence.Conclusion Post-LT metabolic comorbidities remain highly prevalent, with dyslipidemia more common in HIV and diabetes in non-HIV recipients. MASLD develops in approximately one-fifth of recipients, apparently without difference per HIV serostatus, underscoring that cardiometabolic dysfunction is a shared and clinically relevant burden after LT. These data highlighted the need of structured surveillance strategies for metabolic syndrome components and MASLD, together with early cardiovascular risk assessment in a context of integrated and multidisciplinary metabolic care after LT.Abstract P104 Figure 1–2Abstract P104 Table 1Characteristics of liver recipients at liver transplant (LT)",
  "authors": [
    {
      "affiliations": [
        "Unit of Infectious Diseases, University Hospital of Modena, Modena, Italy"
      ],
      "name": "A Cervo"
    },
    {
      "affiliations": [
        "Unit of Infectious Diseases, University Hospital of Modena, Modena, Italy"
      ],
      "name": "M Albertini"
    },
    {
      "affiliations": [
        "Unit of Infectious Diseases, University Hospital of Modena, Modena, Italy"
      ],
      "name": "F Casari"
    },
    {
      "affiliations": [
        "Unit of Infectious Diseases, University Hospital of Modena, Modena, Italy",
        "Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio-Emilia, Modena, Italy"
      ],
      "name": "J Milic"
    },
    {
      "affiliations": [
        "Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University Hospital of Modena, Modena, Italy"
      ],
      "name": "B Catellani"
    },
    {
      "affiliations": [
        "Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio-Emilia, Modena, Italy",
        "Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University Hospital of Modena, Modena, Italy"
      ],
      "name": "P Magistri"
    },
    {
      "affiliations": [
        "Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University Hospital of Modena, Modena, Italy"
      ],
      "name": "G Guerrini"
    },
    {
      "affiliations": [
        "Unit of Infectious Diseases, University Hospital of Modena, Modena, Italy",
        "Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio-Emilia, Modena, Italy"
      ],
      "name": "C Mussini"
    },
    {
      "affiliations": [
        "Division of Gastroenterology and Hepatology, Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital, Montreal, Canada"
      ],
      "name": "G Sebastiani"
    },
    {
      "affiliations": [
        "Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio-Emilia, Modena, Italy",
        "Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University Hospital of Modena, Modena, Italy"
      ],
      "name": "F Di Benedetto"
    },
    {
      "affiliations": [
        "Unit of Infectious Diseases, University Hospital of Modena, Modena, Italy",
        "Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio-Emilia, Modena, Italy"
      ],
      "name": "G Guaraldi"
    }
  ],
  "title": "P104 Post-transplant comorbidities and MASLD development in liver recipients with and without HIV infection",
  "uid": "c906985e-cf33-571f-9521-0c3744790e94"
}