Metabolic Dysfunction‐Associated Steatohepatitis and the Progression of Cognitive Decline in Older Thai People With HIV
This prospective HIV-NAT cohort in Bangkok followed 291 people with HIV aged at least 50 years from 2015–2024; 60 participants, or 20.6%, met non-invasive criteria for MASH at baseline. Over a median 5.9 years, baseline MASH was associated with steeper decline in Thai-validated MoCA scores after adjustment for multiple metabolic, social, and HIV-related factors, whereas MASLD without the MASH signal was not associated with decline. The findings support integrated liver and cognitive surveillance but do not show that treating MASH prevents cognitive deterioration.