Soares C, Samara A, Yuyun MF, et al. - Relative to HIV‐negative people, those living with HIV were found to have higher prevalence of noncalcified coronary plaques and similar prevalence of coronary artery calcium. Earlier development of a more vulnerable form of subclinical atherosclerosis may happen in people with HIV.

• A meta‐ analysis of studies of coronary artery calcium and coronary plaque in people living with HIV was conducted.

• A total of 43 reports representing 27 unique studies with 10,867 participants were included.

• For HIV‐positive and -negative participants, the pooled estimate of percentage with coronary artery calcium >0 was 45% and 52%, respectively; this difference lost significance post-adjustment.

• For HIV‐positive vs ‐negative persons, the odds ratio of coronary artery calcium progression was 1.64, and pooled estimate for prevalence of noncalcified plaque was 49% vs 20%, respectively.

• Odds ratio for noncalcified plaque for HIV+ vs HIV- participants was estimated to be 1.23 (95% CI, 1.08–1.38).