Talia Sainz Costa, M.D., from the University General Hospital Gregorio Maranon in Madrid, Spain, and colleagues used echocardiography to evaluate carotid IMT in 150 HIV-infected pediatric and adolescent patients and 150 controls. Anthropometric and lipid measures were recorded.The researchers found that IMT was significantly thicker in HIV patients compared with control subjects (0.434 versus 0.424; P = 0.018). HIV was independently associated with thicker IMT (odds ratio, 2.68) after adjustment for age, sex, body mass index, and smoking status. In subgroup analysis of 34 patients with HIV and 11 controls for whom immune activation markers were determined, frequencies of activated T CD4+ cells were significantly higher among HIV infected patients. Compared to patients with undetectable viral loads or control subjects, treated and viremic patients had the highest frequency of CD4+ and CD8+ activation and senescence.