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Background: <p>In adults living with HIV, non-invasive biomarkers have been described for the early identification of metabolic dysfunction-associated steatotic liver diseases (MASLD). However, this issue remains unexplored in children and young people with vertical HIV (YWVH), among whom MASLD prevalence is around 30%.</p> Methods: <p>To identify biomarkers associated with MASLD in YWVH under sustained viral suppression with antiretroviral therapy, we analysed plasma lipid species, plasma bile acid profile, and gut microbiome composition in a cross-sectional cohort of 10 YWVH with MASLD and 19 YWVH without clinical evidence of MASLD (control).</p> Results: <p>Here we show that YWVH with MASLD have significantly increased circulating levels of eight specific lipid molecules and one bile acid, ursodeoxycholic acid (UDCA). UDCA and two triglycerides (TG54:5 and TG56:7) are identified as key biomolecules with strong discriminatory potential. The regression model incorporating these markers, along with hepatic steatosis index (HSI) and triglycerides-glucose index (TyG), demonstrates the highest predictive accuracy for MASLD (AUC of 0.932). UDCA correlates positively with <i>Blautia</i> and <i>Collinsella</i> genus (<i>p</i> = 0.040 and <i>p</i> = 0.021, respectively), and negatively with <i>Faecalibacterium</i> (<i>p</i> = 0.030). Notably, principal component analysis based on bile acid levels reveals two possible subpopulations within the control group, one potentially at higher risk for MASLD.</p> Conclusions: <p>Combining UDCA, TG54:5 and TG56:7 with the validated HSI score provides a potential model with high specificity and sensitivity for predicting MASLD in YWVH. Moreover, early alterations in the bile acid profile may help identify YWVH at risk of developing MASLD.</p>

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Metabolomics for searching non-invasive biomarkers of metabolic dysfunction-associated steatotic liver disease in youth with vertical HIV

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月23日

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  • Silvia Chafino,
  • Laura Tarancon-Diez,
  • Jara Hurtado-Gallego,
  • Marina Flores-Piñas,
  • Sonia Alcolea,
  • Antonio Olveira,
  • María Luisa Navarro,
  • Salvador Fernández-Arroyo,
  • Consuelo Viladés,
  • Maria Luisa Montes,
  • Francesc Vidal,
  • Joaquim Peraire,
  • Anna Rull,
  • Talía Sainz

摘要

Background:

In adults living with HIV, non-invasive biomarkers have been described for the early identification of metabolic dysfunction-associated steatotic liver diseases (MASLD). However, this issue remains unexplored in children and young people with vertical HIV (YWVH), among whom MASLD prevalence is around 30%.

Methods:

To identify biomarkers associated with MASLD in YWVH under sustained viral suppression with antiretroviral therapy, we analysed plasma lipid species, plasma bile acid profile, and gut microbiome composition in a cross-sectional cohort of 10 YWVH with MASLD and 19 YWVH without clinical evidence of MASLD (control).

Results:

Here we show that YWVH with MASLD have significantly increased circulating levels of eight specific lipid molecules and one bile acid, ursodeoxycholic acid (UDCA). UDCA and two triglycerides (TG54:5 and TG56:7) are identified as key biomolecules with strong discriminatory potential. The regression model incorporating these markers, along with hepatic steatosis index (HSI) and triglycerides-glucose index (TyG), demonstrates the highest predictive accuracy for MASLD (AUC of 0.932). UDCA correlates positively with Blautia and Collinsella genus (p = 0.040 and p = 0.021, respectively), and negatively with Faecalibacterium (p = 0.030). Notably, principal component analysis based on bile acid levels reveals two possible subpopulations within the control group, one potentially at higher risk for MASLD.

Conclusions:

Combining UDCA, TG54:5 and TG56:7 with the validated HSI score provides a potential model with high specificity and sensitivity for predicting MASLD in YWVH. Moreover, early alterations in the bile acid profile may help identify YWVH at risk of developing MASLD.