People living with HIV often face liver problems, and many of them also don’t have enough vitamin D in their bodies. Scientists reviewed research to understand how these three things—HIV, liver disease, and low vitamin D—might be connected. While we know vitamin D is important for immune health and liver function, researchers haven’t proven yet that fixing vitamin D levels will help liver disease in HIV patients. This review suggests doctors should start checking vitamin D levels as part of regular care for people with HIV, and more studies are needed to see if vitamin D supplements could help protect the liver.

The Quick Take

  • What they studied: How vitamin D deficiency, HIV infection, and liver disease might be connected and affect each other in people living with HIV
  • Who participated: This was a review of existing research rather than a new study with participants. Scientists looked at published studies about HIV, liver disease, and vitamin D in both HIV-positive and HIV-negative people
  • Key finding: People with HIV commonly have low vitamin D levels AND liver problems, and these may be linked through how the immune system works and inflammation in the body, but scientists haven’t proven that raising vitamin D levels will fix liver disease
  • What it means for you: If you have HIV, ask your doctor to check your vitamin D levels as part of your regular care. While we can’t say for sure that vitamin D supplements will help your liver, maintaining healthy vitamin D levels is important for overall health. Don’t start supplements without talking to your doctor first

The Research Details

This was a review study, which means scientists didn’t do a new experiment themselves. Instead, they searched through medical databases to find all the published research about HIV, liver disease, and vitamin D. They read through hundreds of studies and picked out the most important and reliable ones to analyze together.

The researchers looked for studies that explained how liver disease develops in people with HIV, how vitamin D works in the body, and whether low vitamin D is connected to liver problems. They also compared what happens in people with HIV to what happens in people without HIV to see if the patterns were similar.

This type of study is useful because it brings together all the current knowledge on a topic and helps doctors understand what we know and what we still need to learn.

A review study like this is important because it helps doctors see the big picture. Instead of looking at one small study, scientists can combine information from many studies to spot patterns. This helps identify areas where more research is needed and can guide doctors in how they care for patients right now, even before we have all the answers.

This review was published in a respected medical journal focused on HIV care, which means it went through expert review. However, because this is a review of other studies rather than a new experiment, the strength of the findings depends on the quality of the studies reviewed. The authors were honest about what we know for certain versus what is still being investigated. They noted that more research is needed to prove whether vitamin D actually helps liver disease in HIV patients.

What the Results Show

The review found that liver disease is very common in people with HIV, even when their HIV is well-controlled with medications. The most common type of liver disease in this group is now metabolic dysfunction-associated steatotic liver disease (MASLD), which is basically fat building up in the liver. This is similar to what happens in people without HIV who are overweight or have metabolic problems.

At the same time, vitamin D deficiency is also very common in people with HIV. The researchers found that in studies of people without HIV, low vitamin D is connected to higher rates of MASLD and liver scarring (fibrosis). This suggests that the same connection might exist in people with HIV, though it hasn’t been proven yet.

The review identified several ways that vitamin D deficiency, HIV, and liver disease might be connected: vitamin D helps control the immune system and inflammation, and both of these go wrong in people with HIV and in liver disease. Vitamin D also helps protect cells from damage caused by harmful molecules called free radicals. When vitamin D is low, all of these protective functions may not work as well.

The researchers also noted that people with HIV face extra challenges for liver health beyond just vitamin D. Many have other infections like hepatitis B or C that damage the liver. Some HIV medications can be hard on the liver. Alcohol use is also more common in this population and damages the liver. All of these factors together create a perfect storm for liver disease.

This review brings together what we know from many different studies. Previous research in people without HIV has shown that vitamin D deficiency is linked to liver disease, but this connection hasn’t been well-studied in people with HIV. This review suggests that the biological reasons why vitamin D matters for the liver should apply to HIV patients too, but we need specific studies in this group to be sure.

The biggest limitation is that this is a review of existing research, not a new study proving cause and effect. The authors were clear that while the connection between vitamin D deficiency and liver disease is biologically plausible (makes sense based on how the body works), it hasn’t been proven to actually cause liver disease in people with HIV. Most of the vitamin D research comes from people without HIV, so we can’t be completely sure the same patterns apply. The review also noted that studies of liver disease in HIV patients use different methods to measure the disease, making it hard to compare results across studies.

The Bottom Line

MODERATE confidence: People with HIV should have their vitamin D levels checked regularly as part of their standard care. If levels are low, talk to your doctor about whether supplements make sense for you. HIGH confidence: Maintain overall liver health by avoiding excess alcohol, staying at a healthy weight, and taking HIV medications exactly as prescribed. LOW confidence: Vitamin D supplements may help protect the liver, but we don’t have proof yet—more research is needed.

This research is most relevant for people living with HIV, their doctors, and HIV specialists. It’s also important for researchers studying HIV care. People without HIV who have liver disease may find some information useful, but the focus here is on HIV patients. If you have HIV and liver disease, or if you have HIV and metabolic problems, this is especially relevant to you.

If your doctor recommends vitamin D supplements, it typically takes several months to build up vitamin D levels in your body. However, we don’t yet know how long it would take to see benefits for liver health. This is one reason why more research is needed. In the meantime, focus on other proven ways to protect your liver, which can show benefits within weeks to months.

Want to Apply This Research?

  • Track your vitamin D supplementation (if prescribed) by logging daily doses, and note any lab results when you get vitamin D levels checked. Set a reminder to take supplements at the same time each day if your doctor recommends them.
  • Work with your doctor to schedule regular vitamin D testing as part of your HIV care routine. If deficient, follow your doctor’s recommendation for supplementation. Also track behaviors that support liver health: alcohol intake (aim for none or minimal), weight management, and medication adherence.
  • Set quarterly reminders to discuss vitamin D status with your healthcare provider. Log any liver-related symptoms or concerns. Track overall metabolic health markers like weight and energy levels. Keep records of all lab work related to liver function and vitamin D levels to share with your care team.

This review summarizes scientific research but is not medical advice. People with HIV should work with their healthcare provider to determine if vitamin D testing and supplementation are appropriate for their individual situation. Do not start, stop, or change any medications or supplements without consulting your doctor. This research suggests vitamin D deficiency may be connected to liver disease in HIV patients, but does not prove that vitamin D supplements will prevent or treat liver disease. More research is needed. If you have HIV and liver disease, work with an HIV specialist or hepatologist for comprehensive care.