Looking to determine how HIV or antiretrovirals may influence HIV-positive people’s elevated risk of atherosclerosis (hardened arteries), researchers have found that, among nonsmokers, only the virus is linked to this precursor to heart attack and stroke.

The investigators found that the levels of carotid intima-media thickness, which is a measure of cardiovascular health, were raised among those who had been living with the virus for eight years or more, regardless of their treatment status.

The study also found that longer experience with HIV was connected to a lowered anti-inflammatory immune response. This discovery may explain the connection between the virus and hardened arteries, because a diminished anti-inflammatory response has been connected to atherosclerosis in previous research.

While stressing that these findings need to be replicated in larger studies, Moïse Desvarieux, MD, PhD, an associate professor of epidemiology at the Mailman School of Public Health at Columbia University, says there is a “reassuring finding in the sense that the antiretroviral doesn’t seem to increase the risk.”