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In obese patients, the FLI is a poor predictor of significant steatosis and has limited utility for steatosis quantification compared with liver histology. A novel index including triglycerides, glucose, alkaline phosphatase, and BMI may be useful, but requires validation.

The present study suggests that in addition to heavy alcohol use, high-intensity illicit drug use, particularly ≥daily heroin injection and ≥daily crack smoking are risk factors for VL rebound. In addition to the impact of high-intensity drug use on healthcare engagement and ART adherence, some evidence exists on the direct impact of psychoactive substances on ART metabolism and the natural progression of HIV disease. At-risk individuals should be provided additional supports to preserve virologic control and maintain the benefits of ART.

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