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Document the picture: pull your most recent liver enzyme panel, request an abdominal ultrasound or FibroScan if you do not have one in the last twelve months, and keep a one-page summary of values and dates Request an MASLD-specific conversation with a clinician experienced in HIV plus metabolic care (hepatologist, endocrinologist, or an HIV specialty clinic that integrates metabolic pathways), citing SLIM LIVER and the 2025 FDA Wegovy MASH approval Layer at-home hepatitis B and C screening between clinic visits if liver enzymes have been trending up, so a positive result triggers a confirmatory lab test promptly rather than at the next scheduled appointment U.S

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Weeks 1-4: tirzepatide only phase During the tirzepatide-only phase, the primary change is appetite reduction