{
  "abstract": "Background Vitamin D insufficiency and metabolic dysfunction-associated steatotic liver disease (MASLD) are highly prevalent in people with HIV (PWH). Evidence suggests vitamin D may modulate hepatic fat accumulation, but data in HIV are limited. We assessed the relationship between serum 25-hydroxyvitamin D [25(OH)D] and hepatic steatosis severity in a prospective cohort with paired transient elastography (TE) and vitamin D measurements.Methods We included all clinical observations from the Modena HIV Metabolic Clinic, Italy, where TE (liver stiffness measurement [LSM] and controlled attenuation parameter [CAP]) and serum 25(OH)D were measured concurrently. Demographic, anthropometric, metabolic, and HIV-related data were collected at the same visit. Steatosis was graded by CAP (S0: <248 dB/m, S1: 248–268, S2: 269–279, S3: ≥280). Multivariable mixed-effects linear regression was applied with CAP as the dependent variable, adjusting for age, sex, BMI, waist circumference, diabetes, CD4 count, HIV suppression, and ART class.Results A total of 6579 observations from 1614 PWH were analyzed (median age 56 years; 72% male). Baseline characteristics are shown in table 1. Median follow-up time was 4.10 (Q1, Q3: 1.23, 5.56) years. Among 1614 PWH, liver steatosis was distributed as following: 974 (60.3%) in S0, 199 (12.3%) in S1, 93 (5.8%) in S2, and 348 (21.6%) in S3. A progressive worsening of cardiometabolic profile was observed from S0 to S3 (table 1). Median BMI and waist circumference increased stepwise (both p<0.001), paralleled by higher prevalence of sedentary lifestyle (p<0.001). HDL cholesterol decreased, while triglycerides, HOMA-IR, and HbA1c increased significantly across groups (all p<0.001), whereas total and LDL cholesterol did not differ significantly. The prevalence of diabetes and hypertension rose progressively (both p<0.001), as did estimated cardiovascular risk by SCORE-2 (p<0.001) (table 1). In a linear mixed-effects model, higher BMI, larger waist circumference, and lower 25(OH)D levels were independently associated with higher outcome values, while higher CD4 count was associated with lower outcome values (all p < 0.001). Age, sex, diabetes, HIV RNA status, and antiretroviral regimen (PI, NNRTI, or INSTI use) were not significantly associated with the outcome (table 2).Conclusions In this large prospective cohort of PWH, vitamin D deficiency was strongly and independently associated with hepatic steatosis severity, even in a setting where supplementation is systematically recommended. These findings support a potential protective role of vitamin D in liver health and underscore the importance of monitoring vitamin D as part of metabolic and hepatic risk assessment in HIV care. Longitudinal and interventional studies are needed to determine whether correcting deficiency can modify MASLD progression in this population.Abstract OC10 Table 1Baseline characteristics of the population according to liver steatosis severityAbstract OC10 Table 2Multivariable mixed-effects regression for CAP (dB/m)",
  "authors": [
    {
      "affiliations": [
        "Modena HIV Metabolic Clinic, University of Modena and Reggio Emilia, Modena, Italy",
        "Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy"
      ],
      "name": "J Milic"
    },
    {
      "affiliations": [
        "Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy"
      ],
      "name": "L Salmoni"
    },
    {
      "affiliations": [
        "Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy"
      ],
      "name": "S Kaleci"
    },
    {
      "affiliations": [
        "Clinic for Infectious Diseases, University Hospital of Modena, Modena, Italy"
      ],
      "name": "L Gozzi"
    },
    {
      "affiliations": [
        "Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy"
      ],
      "name": "F Cinque"
    },
    {
      "affiliations": [
        "Clinic for Infectious Diseases, University Hospital of Modena, Modena, Italy"
      ],
      "name": "T Albano"
    },
    {
      "affiliations": [
        "Clinic for Infectious Diseases, University Hospital of Modena, Modena, Italy"
      ],
      "name": "M Ricciardetto"
    },
    {
      "affiliations": [
        "Clinic for Infectious Diseases, University Hospital of Modena, Modena, Italy"
      ],
      "name": "I Avanzini"
    },
    {
      "affiliations": [
        "Clinic for Infectious Diseases, University Hospital of Modena, Modena, Italy"
      ],
      "name": "E Delmonte"
    },
    {
      "affiliations": [
        "Clinic for Infectious Diseases, University Hospital of Modena, Modena, Italy"
      ],
      "name": "M Menozzi"
    },
    {
      "affiliations": [
        "Clinic for Infectious Diseases, University Hospital of Modena, Modena, Italy"
      ],
      "name": "G Cuomo"
    },
    {
      "affiliations": [
        "Clinic for Infectious Diseases, University Hospital of Modena, Modena, Italy"
      ],
      "name": "G Mancini"
    },
    {
      "affiliations": [
        "Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy"
      ],
      "name": "R Lombardi"
    },
    {
      "affiliations": [
        "Modena HIV Metabolic Clinic, University of Modena and Reggio Emilia, Modena, Italy",
        "Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy",
        "Clinic for Infectious Diseases, University Hospital of Modena, Modena, Italy"
      ],
      "name": "C Mussini"
    },
    {
      "affiliations": [
        "Division of Gastroenterology and Hepatology, and Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada"
      ],
      "name": "G Sebastiani"
    },
    {
      "affiliations": [
        "Modena HIV Metabolic Clinic, University of Modena and Reggio Emilia, Modena, Italy",
        "Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy",
        "Clinic for Infectious Diseases, University Hospital of Modena, Modena, Italy"
      ],
      "name": "G Guaraldi"
    }
  ],
  "title": "OC10 Vitamin D status and hepatic steatosis in people with HIV: evidence from paired measurements",
  "uid": "dce8caf8-96e1-50e7-835e-8f5649b98106"
}