{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:09:01Z","timestamp":1791486541995,"version":"4.3.4"},"reference-count":41,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T00:00:00Z","timestamp":1700179200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002873","name":"Chulalongkorn University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002873","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012527","name":"Office of the Higher Education Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012527","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The link between fatty liver diseases and cognitive impairment among people living with HIV (PLWH) remains unclear. We investigated the association of steatotic liver disease (SLD), advanced liver fibrosis and non\u2010alcoholic steatohepatitis (NASH) with significant activity and liver fibrosis with cognitive impairment in PLWH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cognitive performance was assessed for PLWH aged \u226550\u2009years on stable antiretroviral therapy (ART) with the Thai\u2010validated version of the Montreal Cognitive Assessment (MoCA), and a cut\u2010off of &lt;25\/30 was used to define cognitive impairment. SLD and NASH with significant activity and liver fibrosis were defined as having a controlled attenuation parameter value \u2265248\u2009dB\/m and a FibroScan\u2010AST (FAST) score\u2009\u22650.67, respectively. Multivariable logistic regression was employed to investigate the association of cognitive impairment with SLD or NASH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 319 PLWH (63.3% male and 98% had HIV\u20101 RNA \u226450 copies\/mL) included, 74 (38%) had SLD. NASH with significant activity and liver fibrosis was present in 66 (20.1%) participants. Some 192 (60.2%) participants had cognitive impairment. In a multivariable analysis, NASH with significant activity and liver fibrosis was significantly associated with cognitive impairment (adjusted odds ratio [aOR] 2.01, 95% CI 1.02\u20133.98, <jats:italic>p<\/jats:italic>\u2009=\u20090.04), after adjusting for HIV\u2010related parameters, age, sex, body mass index, employment status, education, income level, smoking, alcohol use, diabetes mellitus, hypertension and HIV\u2010related parameters. The association of a lone diagnosis of SLD and cognitive impairment was not statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>NASH with significant activity and liver fibrosis was associated with lower cognitive performance, even after controlling for demographics and HIV disease parameters. Additional research is needed to better understand the underlying mechanisms.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13579","type":"journal-article","created":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T22:44:50Z","timestamp":1700261090000},"page":"1233-1243","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of steatotic liver disease and non\u2010alcoholic steatohepatitis on cognitive impairment in people living with <scp>HIV<\/scp>: A cross\u2010sectional study"],"prefix":"10.1111","volume":"24","author":[{"given":"Win Min","family":"Han","sequence":"first","affiliation":[{"name":"HIV\u2010NAT Thai Red Cross AIDS Research Centre  Bangkok Thailand"},{"name":"Kirby Institute, UNSW Sydney  Sydney Australia"},{"name":"Center of Excellence in Tuberculosis, Department of Medicine, Faculty of Medicine Chulalongkorn University  Bangkok 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