{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:58:12Z","timestamp":1790927892936,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We aimed to determine the prevalence of metabolic disorders, liver steatosis and metabolic dysfunction\u2010associated steatotic liver disease (MASLD) in a cohort of middle\u2010aged women with HIV (WoWH) and to explore associations between liver steatosis, visceral fat depots and carotid atherosclerosis. We also assessed the contribution of lifestyle, HIV\u2010 and antiretroviral therapy (ART)\u2010related factors to liver steatosis and the accuracy of United States National Cholesterol Education Program\/Adult Treatment Panel III (NCEP\u2013ATP III) criteria in identifying at\u2010risk patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between 1 April and 31 July 2025, all ART\u2010experienced WoWH aged \u226540\u2009years received comprehensive metabolic and laboratory assessment, including abdominal and carotid Doppler ultrasound (US). Visceral fat depots were evaluated, and metabolic syndrome (MetS) was defined according to NCEP\u2013ATP III criteria. Demographic, clinical and immunovirological data were collected. Logistic regression analyses identified factors associated with liver steatosis. Spearman correlations assessed associations between steatosis and fat distribution, and receiver operating characteristic (ROC) curves evaluated NCEP\u2013ATP III accuracy in identifying liver steatosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 98 WoWH, 55 (56%) had at least grade I liver steatosis, 24 (25%) had MetS. Overall, MASLD was diagnosed in 41 participants (76%). Slight carotid intima\u2010media thickness (cIMT) increases were observed, and 35 participants (36%) had carotid plaques. MetS was the main risk factor for steatosis (OR 14.14, 95% C.I. 3.23\u201384.40,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), with no HIV\u2010 or ART\u2010related associations. Progressive liver steatosis correlated with increasing retroperitoneal (rho\u2009=\u20090.393;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0001), subcutaneous (rho\u2009=\u20090.277;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009= 0.005) and epicardial fat (rho\u2009=\u20090.312;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) thickness. Conversely, epicardial fat thickness was not linked to cIMT. NCEP\u2013ATP III criteria showed limited accuracy (AUC\u2009=\u20090.67) in identifying patients at risk for liver steatosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In the URSULA cohort, hepatic steatosis\u2014largely driven by MetS\u2014was highly prevalent and associated with abnormal visceral fat depots. US may offer a cost\u2010effective tool for fast metabolic surveillance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.70290","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T12:58:05Z","timestamp":1785243485000},"page":"1650-1662","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>UltRaSoUnd<\/scp>\n                    \u2010guided\n                    <scp>evaLuAtion<\/scp>\n                    of metabolic health in a cohort of midlife women with\n                    <scp>HIV<\/scp>\n                    : The\n                    <scp>URSULA<\/scp>\n                    study"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9896-489X","authenticated-orcid":false,"given":"Mariacristina","family":"Poliseno","sequence":"first","affiliation":[{"name":"Clinic of Infectious Diseases, DiMePRe\u2010J University of Bari \u201cAldo Moro\u201d  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Capruzzi","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases, DiMePRe\u2010J University of Bari \u201cAldo Moro\u201d  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Cianciaruso","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases, DiMePRe\u2010J University of Bari \u201cAldo Moro\u201d  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Colavito","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases, DiMePRe\u2010J University of Bari \u201cAldo Moro\u201d  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicia","family":"Dalitto","sequence":"additional","affiliation":[{"name":"Clinic of Internal Medicine, AOUC Policlinico di Bari  Bari 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