Metabolic complications such as dyslipidemia, insulin resistance, and altered fat distribution (loss of subcutaneous fat and relatively increased central fat) are common in adults infected with the human immunodeficiency virus who are receiving highly active antiretroviral therapy and may increase their risk of cardiovascular disease. This review discusses progress in understanding the pathogenetic mechanisms and treatment strategies for addressing cardiovascular risk in this population. This review discusses progress in understanding the pathogenetic mechanisms and treatment strategies for addressing cardiovascular risk in this population. Metabolic complications, including dyslipidemia, insulin resistance, and altered fat distribution (loss of subcutaneous fat and a relative increase in central fat), are common in adults infected with the human immunodeficiency virus (HIV) who are receiving highly active antiretroviral therapy (HAART). These complications may increase these patients' risk of cardiovascular disease. In this review, we discuss progress in the understanding of pathogenetic mechanisms of cardiovascular risk in this population and the development of treatment strategies. Body-Fat Abnormalities Abnormalities in body composition have been reported in 40 to 50 percent of ambulatory HIV-infected patients 1 – 3 ; the proportion is greater in those . . .