The advent of highly active antiretroviral therapy has led to a significant decline in the incidence of mortality and progression to AIDS in HIV-infection. With increased life expectancy, HIV-infected individuals are being affected by cardiovascular disease. Research studies have identified an increased prevalence of traditional coronary risk factors in HIV-infected patients. Additional investigations suggest that the virus itself may independently result in atherosclerosis. Further studies have linked the use of highly active antiretroviral therapy to the atherosclerotic processes. These findings suggest the need to reconsider HIV as one of the traditionally accepted risk factors for coronary artery disease, with treatment aimed at prevention of myocardial infarction.