Liver disease linked to cognitive decline in older Thais with HIV
In a study of older Thai people with HIV, cognitive scores fell 4.79 points in those with an inflammatory liver condition compared with 0.94 without.
Journal of the International AIDS Society
In a prospective observational study, researchers tracked 291 people with HIV aged 50 and older in Thailand over a median of 5.9 years. At the start, 60 participants had metabolic dysfunction-associated steatohepatitis, or MASH, a form of fatty liver disease marked by inflammation. The team tracked cognitive function using a standard screening test. Simpler fatty liver disease was not linked to cognitive decline. However, participants with baseline MASH experienced steeper decline. Their cognitive scores dropped by an average of 4.79 points, compared with 0.94 points in those without MASH, after accounting for age, education and metabolic risks.
Why it matters
As people with HIV live longer, age-related conditions such as cognitive decline become more prominent health concerns. The findings suggest that managing inflammatory liver disease could help preserve brain function during aging in this population.
Caveats
The study was observational, meaning it cannot determine whether liver inflammation directly drives cognitive decline. Liver disease was also identified using a scoring formula rather than a tissue biopsy, and all participants came from a single centre in Thailand.
- HIV infection
- Metabolic dysfunction-associated steatohepatitis
- Cognitive impairment
- FibroScan-AST score
- Metabolic dysfunction-associated steatotic liver disease
- Humans
The paper
Chulalongkorn University
Journal of the International AIDS Society · 1 Oct 2026
