The association between HIV infection and high levels of ICAM-1 reported here expands the limited literature on sub-Saharan Africa6 and is consistent with findings from high-income countries.2 Although other risk factors, such as diabetes, hypercholesterolemia, and ART, can contribute to endothelial activation, we found that this association is independent of those factors. This evidence concerns the gene ICAM1 and Hypercholesterolemia.