Myocardial ECVF was slightly elevated in PWH compared to controls (28.7% vs. 28.2%, p = 0.03). This indicates a small but significant increase in myocardial fibrosis in PWH relative to HIV-uninfected individuals. PWH population also had higher levels of sCD14, GDF-15, and NT-proBNP compared to HIV-uninfected but they minimally reflected HIV-associated elevations in left atrial volume index (LAVI) and myocardial ECVF. Here, NPPB is linked to Myocardial fibrosis.