People living with HIV are particularly susceptible to developing metabolic disorders, including metabolic dysfunction-associated steatotic liver disease and other forms of SLD. However, people living with HIV have been historically excluded from clinical trials and large cohort studies of SLD. Therefore, our understanding of the risk factors and natural history of SLD in this population is poor. Moreover, relevant knowledge gaps on the epidemiology and barriers for adequate health care, such as stigma, hamper adequate responses to the ongoing HIV and SLD syndemic. This Viewpoint provides a comprehensive perspective on how to tackle SLD in people living with HIV by examining the role of social determinants of health in the development of liver disease and metabolic syndrome comorbidities among this population, emphasising the importance of prioritising SLD management, summarising the most urgent needs in the field, and offering recommendations for advancing research to fill key data gaps and protect liver health of people living with HIV.

中文翻译：

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脂肪肝病和艾滋病毒：2030 年议程


HIV 感染者特别容易出现代谢紊乱，包括代谢功能障碍相关的脂肪肝病和其他形式的 SLD。然而，艾滋病毒感染者历来被排除在 SLD 的临床试验和大型队列研究之外。因此，我们对该人群中 SLD 的危险因素和自然史了解甚少。此外，流行病学方面的相关知识差距和适当医疗保健的障碍（例如耻辱）阻碍了对持续的艾滋病毒和 SLD 流行病的充分应对。本观点通过研究健康的社会决定因素在该人群肝病和代谢综合征合并症发展中的作用，提供了如何解决艾滋病毒感染者的 SLD 的全面视角，强调了优先处理 SLD 的重要性，总结了最重要的该领域的迫切需求，并为推进研究提供建议，以填补关键数据空白并保护艾滋病毒感染者的肝脏健康。