---
title: "Steatotic Liver Disease Subtypes in People Living with HIV: Mortality and Cardiovascular Risks in"
id: "pubmed-42670693"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42670693"
content_type: "clinical_feed_article"
specialty: "Infectious Disease"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42670693/"
doi: "10.5009/gnl250555"
published_at: "2026-09-15T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Steatotic Liver Disease Subtypes in People Living with HIV: Mortality and Cardiovascular Risks in
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42670693
- **Specialty:** [Infectious Disease](https://medichelpline.com/clinical-feed/infectious-disease.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42670693/)
- **DOI:** [10.5009/gnl250555](https://doi.org/10.5009%2Fgnl250555)
- **Published At:** 2026-09-15T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This retrospective national cohort study evaluated **steatotic liver disease (SLD)** subtypes and their associations with outcomes in 4,597 Korean people living with HIV (PLWH) using National Health Insurance Service data from 2013–2022. - SLD was defined by a **fatty liver index ≥30** and classified into metabolic dysfunction–associated SLD (**MASLD**), alcohol-associated liver disease (**ALD**), and metabolic dysfunction–associated ALD (**MetALD**). - Overall SLD prevalence among PLWH was 45.7%; of those with SLD, 86.5% had MASLD, 9.7% had MetALD, and 3.8% had ALD. - SLD prevalence in PLWH did not exceed that in propensity-matched controls drawn from the same database. - Over a median follow-up of 6 years, SLD was associated with higher all-cause **mortality** (adjusted hazard ratio [aHR] 1.53; 95% CI 1.03–2.29) after multivariable adjustment. - Subtype-specific associations were observed: **ALD** was linked to increased stroke risk (adjusted subdistribution hazard ratio [aSHR] 3.10; 95% CI 1.04–9.20), and **MetALD** was associated with increased risk of **liver cirrhosis** (aSHR 5.72; 95% CI 1.48–22.10) in competing risk models. - Outcomes (all-cause mortality, cardiovascular diseases, and liver cirrhosis) were analyzed using multivariable Cox proportional hazards and Fine-Gray competing risk models. - The authors conclude integrated management addressing liver health, metabolic dysfunction, and alcohol use is important to reduce adverse outcomes in PLWH with SLD. - Details on specific covariates used in multivariable models, baseline characteristics beyond prevalence, and subgroup analyses were not reported in the abstract and would require the full text for further granularity.
## Clinical Analysis & Structured Key Points
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Epub 2026 Aug 31. # Subtype-Specific Mortality and Cardiovascular Burden in HIV Patients with Steatotic Liver Disease: A Korean National Cohort Study [Jihun Song](https://pubmed.ncbi.nlm.nih.gov/?term=Song+J&cauthor_id=42670693)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670693/#full-view-affiliation-1 "Biomedical Research Center, Korea University Guro Hospital, Seoul, Korea.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42670693/#full-view-affiliation-2 "Department of Biomedical Informatics, Korea University College of Medicine, Seoul, Korea."), [Seogsong Jeong](https://pubmed.ncbi.nlm.nih.gov/?term=Jeong+S&cauthor_id=42670693)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42670693/#full-view-affiliation-2 "Department of Biomedical Informatics, Korea University College of Medicine, Seoul, Korea."), [Jihwan Bang](https://pubmed.ncbi.nlm.nih.gov/?term=Bang+J&cauthor_id=42670693)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42670693/#full-view-affiliation-3 "Division of Infectious Diseases, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea."), [Won Kim](https://pubmed.ncbi.nlm.nih.gov/?term=Kim+W&cauthor_id=42670693)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42670693/#full-view-affiliation-4 "Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42670693/#full-view-affiliation-5 "Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.") Affiliations Expand ### Affiliations * 1 Biomedical Research Center, Korea University Guro Hospital, Seoul, Korea. * 2 Department of Biomedical Informatics, Korea University College of Medicine, Seoul, Korea. * 3 Division of Infectious Diseases, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea. * 4 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea. * 5 Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. * PMID: **42670693** * DOI: [ 10.5009/gnl250555 ](https://doi.org/10.5009/gnl250555) Free article Item in Clipboard # Subtype-Specific Mortality and Cardiovascular Burden in HIV Patients with Steatotic Liver Disease: A Korean National Cohort Study Jihun Song et al. Gut Liver. 2026. Free article Show details Display options Display options Format Abstract PubMed PMID Gut Liver Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Gut+Liver%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Gut+Liver%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42670693/) . 2026 Sep 15;20(5):859-869. doi: 10.5009/gnl250555. Epub 2026 Aug 31. ### Authors [Jihun Song](https://pubmed.ncbi.nlm.nih.gov/?term=Song+J&cauthor_id=42670693)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670693/#short-view-affiliation-1 "Biomedical Research Center, Korea University Guro Hospital, Seoul, Korea.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42670693/#short-view-affiliation-2 "Department of Biomedical Informatics, Korea University College of Medicine, Seoul, Korea."), [Seogsong Jeong](https://pubmed.ncbi.nlm.nih.gov/?term=Jeong+S&cauthor_id=42670693)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42670693/#short-view-affiliation-2 "Department of Biomedical Informatics, Korea University College of Medicine, Seoul, Korea."), [Jihwan Bang](https://pubmed.ncbi.nlm.nih.gov/?term=Bang+J&cauthor_id=42670693)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42670693/#short-view-affiliation-3 "Division of Infectious Diseases, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea."), [Won Kim](https://pubmed.ncbi.nlm.nih.gov/?term=Kim+W&cauthor_id=42670693)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42670693/#short-view-affiliation-4 "Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42670693/#short-view-affiliation-5 "Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.") ### Affiliations * 1 Biomedical Research Center, Korea University Guro Hospital, Seoul, Korea. * 2 Department of Biomedical Informatics, Korea University College of Medicine, Seoul, Korea. * 3 Division of Infectious Diseases, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea. * 4 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea. * 5 Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. * PMID: **42670693** * DOI: [ 10.5009/gnl250555 ](https://doi.org/10.5009/gnl250555) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background/aims:** Steatotic liver disease (SLD) is an emerging comorbidity among people living with human immunodeficiency virus (PLWH), but its subtype-specific burden remains unclear. We aimed to evaluate the prevalence of SLD and its associations with mortality, cardiovascular diseases, and liver cirrhosis (LC). **Methods:** This retrospective cohort study included 4,597 Korean PLWH using data from the National Health Insurance Service (2013-2022). SLD was defined using the fatty liver index (≥30) and categorized into metabolic dysfunction-associated SLD (MASLD), alcohol-associated liver disease (ALD), and metabolic dysfunction-associated ALD (MetALD). Outcomes were all-cause mortality, cardiovascular diseases, and LC, analyzed using multivariable Cox proportional hazards and Fine-Gray competing risk models. **Results:** The prevalence of SLD was 45.7%, predominantly MASLD (86.5%), followed by Met-ALD (9.7%) and ALD (3.8%). SLD prevalence in PLWH was not higher than that in matched controls. Over a median 6-year follow-up, SLD was associated with increased mortality (adjusted hazard ratio, 1.53; 95% confidence interval [CI], 1.03 to 2.29). ALD was linked to higher stroke risk (adjusted subdistribution hazard ratio [aSHR], 3.10; 95% CI, 1.04 to 9.20), and MetALD to higher LC risk (aSHR, 5.72; 95% CI, 1.48 to 22.10). **Conclusions:** As SLD is significantly associated with mortality in PLWH, integrated management focusing on liver health, metabolic dysfunction, and alcohol use is essential to reduce adverse outcomes. **Keywords:** Fatty liver; HIV; Mortality. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ Metabolic Dysfunction-Associated Steatotic Liver Disease and All-Cause and Cause-Specific Mortality. ](https://pubmed.ncbi.nlm.nih.gov/39197834/) Oh R, Kim S, Cho SH, Kim J, Lee YB, Jin SM, Hur KY, Kim G, Kim JH.Oh R, et al.Diabetes Metab J. 2025 Jan;49(1):80-91. doi: 10.4093/dmj.2024.0042. Epub 2024 Aug 28.Diabetes Metab J. 2025.PMID: 39197834Free PMC article. * [ Alcohol-driven phenotypic transition in MASLD and risk of liver-related events. ](https://pubmed.ncbi.nlm.nih.gov/42019869/) Jang S, Song J, Kang ES, Cheon S, Kwak T, Kim Y, Kong S, Choi J, Kang M, Khil J, Kim HJ, Lee J, Lee H, Jeong S.Jang S, et al.JHEP Rep. 2026 Jul;8(7):101866. doi: 10.1016/j.jhepr.2026.101866. Epub 2026 Apr 20.JHEP Rep. 2026.PMID: 42019869Free PMC article. * [ Steatotic liver disease subtypes and risk of hospitalization for sepsis: a nationwide cohort study. ](https://pubmed.ncbi.nlm.nih.gov/42501324/) Seong H, Kim SY, Lee EH, Kim D, Han KD, Han SH.Seong H, et al.Ann Med. 2026 Dec;58(1):2704290. doi: 10.1080/07853890.2026.2704290. Epub 2026 Jul 25.Ann Med. 2026.PMID: 42501324Free PMC article. * [ Associations between steatotic liver disease subtypes and incident atrial fibrillation in young adults: a nationwide cohort study. ](https://pubmed.ncbi.nlm.nih.gov/40855552/) Park J, Chung GE, Yu SJ, Kim YJ, Yoon JH, Han K, Cho EJ.Park J, et al.Cardiovasc Diabetol. 2025 Aug 25;24(1):348. doi: 10.1186/s12933-025-02905-3.Cardiovasc Diabetol. 2025.PMID: 40855552Free PMC article. * [ Prevalence, characteristics and outcomes of patients with metabolic and alcohol related/associated liver disease (MetALD): a systematic review and meta-analysis. ](https://pubmed.ncbi.nlm.nih.gov/39662742/) Tampaki M, Tsochatzis E, Lekakis V, Cholongitas E.Tampaki M, et al.Metabolism. 2025 Feb;163:156101. doi: 10.1016/j.metabol.2024.156101. 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