Accumulation oftriglycerides in the liver can result in non-alcoholic fatty liver disease (NAFLD) and maypresent with varying degrees of liver enzyme abnormalities.32 Evidence suggests that in untreated HIV infection, the absence of cART-relatedtoxicity may have direct impact on liver dysfunction, including NAFLD and NASH.6,33 Nonalcoholic steatohepatitis has been reported to increase the risk of liver enzymeabnormalities among HIV-infected patients.6 As a result, assessment of triglycerides at ART initiation can identify patients atincreased risk of ALT elevations. Here, GPT is linked to Decreased liver function.