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(1) Background: Developing strategies to identify significant liver fibrosis in people with HIV (PWH) is crucial to prevent complications of non-alcoholic fatty liver disease (NAFLD). We aim to investigate if five simple serum biomarkers applied to PWH can optimize a care pathway to identify significant liver fibrosis defined by transient elastography (TE). (2) Methods: A two-tier fibrosis pathway was applied to three prospective cohorts of PWH undergoing TE with CAP. NAFLD was diagnosed as a controlled attenuation parameter ≥ 248 dB/m. Five simple fibrosis biomarkers (FIB-4 < 1.3, BARD score 0–1, NAFLD fibrosis score < −1.455, AST:ALT ratio < 0.8 and APRI < 0.5) were applied as first-tiers to exclude significant liver fibrosis. We determined the decrease in referral for TE that would have occurred based on biomarker assessment and the discordance between low simple fibrosis biomarkers and high TE (≥7.1 kPa), indicating significant liver fibrosis. (3) Results: Of the 1749 consecutive PWH, 15.1% had significant liver fibrosis by TE and 39.1% had NAFLD. The application of the fibrosis biomarkers as first tiers would have resulted in a decrease in TE referrals between 24.9% (BARD score) and 86.3% (APRI). The lowest discordance rate was with NAFLD fibrosis score (8.5%). After adjustments, BMI (odds ratio (OR) 1.12, 95% CI: 1.08–1.17) and triglycerides (OR 1.26, 95% CI: 1.11–1.44) were independent predictors of discordance for APRI < 0.5 and TE ≥ 7.1. The performance of the two-tier pathways was similar in PWH with and without NAFLD. (4) Conclusions: Implementing a two-tier pathway could save a substantial proportion up of TE examinations, reducing costs and helping resource optimization in HIV care. Patients with metabolic risk factors for NAFLD and low fibrosis biomarker may still be considered for TE referral.

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was estimated using the Modification of Diet in Renal Disease calculator. Results: A total of 640 students were studied (M:F¼1:3.8). Their mean age was 23.1AE2.8 years. Thirty three (5.2%) participants had renal dysfunction (estimated glomerular flitration rate < 60ml/min/1.73m 2). The mean age of subjects with renal dysfunction (estimated glomerular flitration rate < 60ml/min/1.73m 2) was significantly higher with an inverse association to renal function (p ¼ 0.005). Two hundred and fifty seven (40.2%) and 58 (9.1%) participants were pre-hypertensive and hypertensive respectively; overweight, abdominal obesity and hypercholesterolaemia were found among 12.2%, 14.2% and 8.1% of subjects respectively. The mean body mass index (p ¼ 0.009) and serum total cholesterol (p ¼ 0.003) were significantly higher among females. There was a higher prevalence of renal dysfunction among females (5.9 v 2.2%, p ¼ 0.12) even though this was not to the significant level Conclusions: The prevalence of renal dysfunction in young adults is lower than current estimates for adults. Increasing age is likely to influence onset of chronic kidney disease while female gender influenced the prevalence of increased body mass and hypercholesterolaemia