The obvious problem, as noted in the comments, is that the VAS (Voltage Amplifier Stage) transistor is connected incorrectly.
Once you get that straightened out you need to look at the biasing. From what I can tell it looks like your bias currents are too high. The input stage looks to be around 20 mA, I would cut that down to 1 to 2 mA. The VAS stage should be maybe 5 to 10 mA.
One way to find the best bias points is to replace the transistor constant current sources with a constant current source model in the simulator, then step the CCS and see at what value you get the least distortion. Do one at a time, Q40 for the input stage, Q41 for the VAS stage, and Q42 for the class A stage. Using the built-in current source allows you to easily change it for testing. Once you get the values correct you can put the transistor ones back in and adjust them to get the correct currents.