A Study to Evaluate the Use of Resmetirom in Participants With MASLD and HIV

Inclusion Criteria: 1. Adults (≥18 years of age) with documented HIV. 2. Documented diagnosis of MASLD established by imaging (ultrasound, CT scan or MRI) or vibration-controlled transient elastography (VCTE) or liver biopsy within 12 months before screening. 3. Hepatic fat fraction ≥8% by MRI-PDFF. 4. Liver stiffness by VCTE ≥8 kPa and CAP≥263 dB/m 5. HIV-1 RNA \<200 copies/mL for ≥6 months on antiretroviral therapy (ART) (must have screening HIV-1 RNA value and one clinical care value within 6 months prior to screening and up to the randomization that meet the criteria). 6. Stable ART regimen for ≥3 months prior to screening and stable up to the randomization and no active plans to change ART while on study. 7. Willingness to participate in the study. Exclusion Criteria: 1. History of significant alcohol consumption (defined as \>2 drinks/day on average for men, \>1 drinks/day on average for women) for at least 3 consecutive months (12 consecutive weeks) within 5 year before screening 2. History of other acute or chronic liver disease, including, but not limited to autoimmune, primary biliary cholangitis, Wilson's disease, alpha 1 antitrypsin deficiency, hemochromatosis, hepatitis B virus (HBV), and ongoing or recent (within the past 3 years) hepatitis C RNA positivity. 3. History of liver transplant. 4. Liver biopsy or radiologic imaging consistent with the clinical presence of cirrhosis or portal hypertension at screening. 5. Participants whose Visit 2 ALT, AST, or alkaline phosphatase (ALP) values exceed their Visit 1 values by more than 50%. 6. Inability to undergo MRI testing 7. Uncontrolled T2DM defined as glycated hemoglobin (HbA1c) \>9.5% at screening. 8. Any of the following laboratory values at screening: 1. ALT or AST \>250 U/L. 2. Total bilirubin (TBL) \>1.5 mg/dL and direct bilirubin \> 0.5 mg/dL (unless due to Gilbert's disease or atazanavir use, per the opinion of the site investigator). 3. Platelet count \<150,000/mm3. 4. Estimated glomerular filtration rate (e-GFR) \<60 mL/min/1.73m2 using the chronic kidney disease-epidemiology collaboration (CKD-EPI) equation 5. International normalized ratio (INR) \>1.3. 6. Albumin \< 3.6 g/dL 9. Liver stiffness measurement (LSM) by VCTE \> 20 kPa 10. Further exclusion criteria apply