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Updated: Jan 10, 2026

Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
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Triglyceride-glucose index and FIB-4 score in relation to cardiovascular disease risk among people with HIV: a

María Luisa Montes1,2, Carmen Busca1,2, Juan Martín-Torres3

  • 1Unidad VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain.

Frontiers in Medicine
|November 24, 2025
PubMed

Insights

People with HIV face high cardiovascular risks. Combining hepatic steatosis/insulin resistance (HS-IR) and liver fibrosis risk assessment improves cardiovascular event prediction in this population.

Area of Science:

  • Cardiology
  • Hepatology
  • Infectious Diseases

Background:

  • People with HIV (PWH) exhibit elevated cardiovascular event (CVE) risk.
  • Hepatic steatosis/insulin resistance (HS-IR) and liver fibrosis are potential contributors to CVEs in PWH.

Purpose of the Study:

  • To investigate CVE incidence in PWH.
  • To evaluate the combined utility of HS-IR and liver fibrosis risk for cardiovascular risk stratification in PWH.

Main Methods:

  • Retrospective analysis of 7,286 PWH from the CoRIS cohort.
  • Calculation of triglyceride-glucose (TyG) index for HS-IR and FIB-4 index for liver fibrosis risk.
  • Competing risk survival regression analysis to assess associations with CVEs.

Main Results:

  • Overall CVE incidence was 3.5 per 1,000 person-years.
  • Abnormal HS-IR and liver fibrosis risk were independently associated with a 2.21-fold increased CVE risk (p < 0.01).
  • Individuals with both abnormal indices had a markedly higher CVE incidence (10.6 vs. 1.4 per 1,000 person-years).

Conclusions:

  • HS-IR and liver fibrosis risk before ART initiation are linked to increased CVEs in PWH.
  • Combined assessment of HS-IR and liver fibrosis risk can enhance cardiovascular risk stratification.
  • These accessible tools aid early identification and intervention for high-risk PWH.
Abstract

Keywords:
HIVMASLDcardiovascular eventshepatic steatosisliver fibrosis

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