1 CORRESPONDING AUTHOR: GIORDANO MADEDDU, MD; GIORDANO.MADEDDU@UNISS.IT INTRODUCTION HIV-infected patients and HIV/HCV co-infected, even if successfully treated, are at increased risk of neu- rocognitive impairment 1,2 . Altered neuropsychological performance and neurocognitive impairment also are frequently reported in patients with chronic HCV in- fection, often at stages characterized as having a lack of signiicant liver ibrosis and cirrhosis 3 . A recent study suggests that FIB-4 index at cART initiation, and its ABSTRACT: — Introduction: HIV-infected patients, even if successfully treated, are at increased risk of neurocognitive im- pairment. Altered neuropsychological performance and neurocognitive impairment are frequently report- ed in patients with chronic HCV infection, often at stages characterized as having a lack of significant liver fibrosis and cirrhosis. A recent study suggests that FIB-4 index at cART initiation, and its modification over time are risk factors for major liver-related events and death, independently of infection with HCV. — Purpose of the study: We investigated the relationship between FIB-4 values and neurocognitive perfor- mance in HIV-infected patients without HCV and/or HBV coinfection. — Patients and Methods: We enrolled consecutive HIV-infected outpatients. In each patient demographic, clini- cal and therapeutic characteristics were recorded from clinical records. Each patient underwent a complete neu- rocognitive assessment with a battery of 8 tests: Trail Making Test-A (TMT-A), Trail Making Test-B (TMT-B), Dig- it Span (DSp), immediate (Rey 15) and delayed (D-Rey 15) recall of Rey’s 15, Digit Symbol (DSy), Letter fluency test (Flu), Rey complex figure (R-Fig). We also considered 2 global z-score NPZ-4 (TMA-Z+TMB-Z+DSp-Z+DSy- Z) and NPZ-8 (TMA-Z+TMB-Z+DSp-Z+DSy-Z+15-Z+15dif-Z+Flu-Z+FigR-Z). FIB-4 was also calculated considering values <1.45 were indicative of low level of hepatic fibrosis, values between 1.46 and 3.25 of moderate fibrosis and values >3.25 of advanced fibrosis. Patients with HCV and/or HBV hepatic coinfection were excluded. — Results: we enrolled 52 HIV-infected patients with a median age of 44 (IQR 38.5-50), 33 (63.4%) were males and 29 (55.7%) heterosexuals. Twelve (23%) had a previous AIDS diagnosis. Median CD4 cells count was 793 (IQR 616-1231.5) cells/mm3 and 46 (88.5%) had an undetectable HIV RNA. According to FIB-4 re- sults, 48 (92.3%) patients had values <1.45 and 4 (7.7%) between 1.46 and 3.25 (26.2%), no patient had a value >3.25. Median FIB-4 value was 0.85 (IQR 0.70-1.06).FIB-4 levels were significantly correlated with lon- ger duration of known HIV infection (Rho=0.29, p<0.05) and longer cART exposure (Rho=0.36, p<0.05) whereas no correlation was evidenced with level of education, previous AIDS diagnosis, CD4 cell nadir, cur- rent CD4 count, negative HIV RNA, NPZ-4 and NPZ-8 results. — Conclusions: Most HIV mono-infected patients had a fully suppressed HIV RNA and FIB-4 values consistent with low levels of hepatic fibrosis. Higher FIB-4 results were significantly correlated with longer HIV infection and cART duration but not with neurocognitive performance, suggesting a dissociation between long-term hepatic toxicity and neuroprotective function of antiretrovirals. — Keywords: HIV, FIB-4, Neurocognitive impairment. 1 Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy 2 Unit of Infectious Diseases, Pescara Hospital, Pescara, Italy. V. Lai 1 , B. Zizi 1 , F. Vadini 2 , G.M. Calia 1 , P. Bagella 1 , V. Fiore 1 , F. Peruzzu 1 , G. Caruana 1 , S. Babudieri 1 , M.S. Mura 1 , G. Madeddu 1 FIB-4 values and neurocognitive function in HIV-infected patients without hepatic coinfections INFECT DIS T ROP MED 2016; 2 (2): E293