Prior studies among PLWH suggest that having a history of more severe immunosuppression (ie, low nadir CD4+ T cell count) is associated with more subclinical atherosclerosis, endothelial dysfunction and vascular stiffness.24 26 27 Lower nadir CD4+ T cell count is also associated with higher levels of chronic inflammation and immune activation even after viral suppression on ART.28 29. The gene discussed is CD4; the disease is endothelial dysfunction.