We previously reported that poor viral control (ie, high viral load and low CD4 count) was associated with an increased risk of prevalent pulmonary hypertension.4 Others have reported a lack of an association between viral control and risk of pulmonary hypertension.22 These studies (including our previous report)4 considered only measures of viral control obtained nearest in time to the assessment of pulmonary pressure, which does not capture variation in viral load or CD4 cell count over time. This evidence concerns the gene CD4 and pulmonary arterial hypertension.