Overall, our study on 117 HIV-positive patients on cART does not indicate that genetic polymorphisms predisposing to NAFLD in HIV-negative individuals are also major risk factors for drug-related liver steatosis induced by cART, because we did not detect genetic effects corresponding in strength to the role of the “master regulators” PNPLA3 and TM6SF2 in alcoholic and non-alcoholic fatty liver disease. Here, PNPLA3 is linked to metabolic dysfunction-associated steatotic liver disease.