Studies published before the introduction of highly active antiretroviral therapy (HAART) tracked the incidence and course of HIV infection in relation to cardiac illness in both children and adults. These studies show that subclinical echocardiographic abnormalities independently predict adverse outcomes and identify high-risk groups to be targeted for early intervention and therapy. The introduction of HAART has altered cardiovascular manifestations in HIV. On the one hand, HAART has significantly modified the course of HIV disease, lengthened survival, and improved the quality of life of HIV-infected patients. On the other hand, the early data have raised concerns that HAART is associated with an increase in both peripheral and coronary arterial diseases, creating an intriguing clinical scenery. This book focuses on new clinical and biological insight related to HIV-associated metabolic and cardiovascular complications in the HAART era.