USE OF THE FIBROSIS-4 INDEX FOR SCREENING LIVER FIBROSIS IN PEOPLE LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS AND
Arthur Cavalcante Lopes1,1, Amanda Aymoré Santos1,1, Ivo da Cunha Nunes1,1
1Universidade Federal do Pará (UFPA), Instituto de Ciências Médicas (ICM), Belém, PA, Brasil.
Background And Objective:
To evaluate the performance of the Fibrosis-4 (FIB-4) index for liver fibrosis screening in people living with HIV (PLWH) with glucose metabolism disorders (diabetes and prediabetes).
Methods:
Cross-sectional study including 100 PLWH on continuous antiretroviral therapy at a reference center in Brazil (March-November 2025). Clinical, laboratory, and ultrasonographic data were collected for FIB-4 calculation. Participants with diabetes were compared to non-diabetic individuals.
Results:
Altered FIB-4 values were observed in 32 participants, with no sex differences. Mild steatosis (S≥1) was present in 47.0%, and clinically significant steatosis (S≥2) in 11.0%. S≥1 was associated with higher BMI, waist circumference, visceral fat, total cholesterol, LDL, triglycerides, and ALT levels. FIB-4 showed limited ability to classify S≥2.
Conclusion:
FIB-4 is useful for fibrosis screening, particularly to exclude advanced disease, but does not adequately identify clinically significant steatosis (S≥2). Its use should be combined with metabolic assessment and elastography when values are ≥1.3.
