biostudies-literatureUnknown12(11)Wegermann K<h4>Background</h4>Men are at higher risk for metabolic dysfunction-associated steatotic liver disease (MASLD) with clinically significant fibrosis (CSF) than premenopausal women, but data are lacking in persons with HIV (PWH). The aim of this study was to discover prevalence and severity of MASLD in PWH by sex assigned at birth and menopausal status.<h4>Methods</h4>We examined participants from the prospective, cross-sectional HIV NASH CRN who had suppressed HIV-1 RNA, self-reported sex assigned at birth and menopause status, and underwent transient elastography (TE). The primary outcome was MASLD (controlled attenuation parameter [CAP] ≥ 263 dB/m, ≥1 cardiometabolic risk factor, Alcohol Use Disorders Identification Test score <8) with CSF (MASLD-CSF, TE Liver Stiffness Measurement ≥ 8 kPOpen forum infectious diseasesofaf637https://www.ebi.ac.uk/biostudies/studies/S-EPMC12604012biostudies-literatureFemale Sex is Protective Against MASLD With Clinically Significant Fibrosis in a Large Cross-sectional Cohort of Persons With HIV.PMC12604012Lloyd APrice JCWegermann KChalasani NWoreta TSterling RKSuzuki ABoyd LDebroy PLi YSarmiento ELoomba RWilson LALake JECrandall HfalseFemale Sex is Protective Against MASLD With Clinically Significant Fibrosis in a Large Cross-sectional Cohort of Persons With HIV.<h4>Background</h4>Men are at higher risk for metabolic dysfunction-associated steatotic liver disease (MASLD) with clinically significant fibrosis (CSF) than premenopausal women, but data are lacking in persons with HIV (PWH). The aim of this study was to discover prevalence and severity of MASLD in PWH by sex assigned at birth and menopausal status.<h4>Methods</h4>We examined participants from the prospective, cross-sectional HIV NASH CRN who had suppressed HIV-1 RNA, self-reported sex assigned at birth and menopause status, and underwent transient elastography (TE). The primary outcome was MASLD (controlled attenuation parameter [CAP] ≥ 263 dB/m, ≥1 cardiometabolic risk factor, Alcohol Use Disorders Identification Test score <8) with CSF (MASLD-CSF, TE Liver Stiffness Measurement ≥ 8 kP2025-01-01T00:00:00Z2025 Nov2026-05-18T03:20:43.314Z2026-05-18T03:13:10.487ZS-EPMC126040124122988010.1093/ofid/ofaf637