Evaluation of Triglyceride-Glucose (TyG) Index in Individuals Living with HIV Under Antiretroviral Therapy (ART)

Introduction: Fasting triglyceride-glucose (TyG) index, which indirectly evaluates insulin resistance, is an important risk parameter in various diseases, especially cardiovascular diseases (CVD). There are very limited number of studies evaluating TyG index in individuals living with HIV, where the incidence of these diseases is increased. This study was conducted to determine the change in TyG index during the first year of antiretroviral therapy and the relationship between TyG index and CD4/CD8 ratio. Methods Data of patients living with HIV who were followed up between 2011 and 2024 were retrospectively analyzed. 348 ART-naive, non-diabetic patients who completed their first year of follow-up under ART were included in the study. TyG index was calculated according to the formula Ln [fasting triglyceride (mg/dL) x fasting glucose (mg/dL)/2]. Patients with TG values ​​>150 mg/dl at the time of diagnosis constituted the hypertriglyceridemic (HTG) group, and patients with TG values ​​≤150 mg/dl at the time of diagnosis constituted the non-hypertriglyceridemic (NHTG) group. Results Hypertriglyceridemia was detected in 146 (42%) of our patients in the initial evaluation at the time of diagnosis. No correlation was found between TyG index and lymphocyte subgroups at the time of diagnosis (p > 0.05). However, a positive linear correlation was found between TyG index and CD8 + T cell count and percentage (r = 0.192, p < 0.001; r = 0.118, p < 0.001, respectively) and a negative linear correlation was found between TyG index and CD4/CD8 ratio (r=-0.092, p = 0.007) during the first year of ART. TyG index did not show any significant change in the months after starting ART in the NHTG group, while it decreased statistically significantly in the HTG group (p < 0.001). Conclusion The decrease in TyG index with control of immune activation under ART is promising as an important follow-up parameter. Therefore, data from new prospective studies are needed to analyze conditions such as CVD and metabolic syndrome that will occur in the longer term under ART.