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We hypothesized that increased macrophage-specific arterial infiltration would relate to plaque composition and systemic immune activation among PWH. We applied a novel targeted molecular imaging approach (technetium-99m [99mTc]\u2013tilmanocept single photon emission computed tomography [SPECT]\/CT) and comprehensive immune phenotyping.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Aortic 99mTc-tilmanocept uptake was significantly higher among PWH (n = 20) than participants without HIV (n = 10) with similar 10-year ASCVD risk (P = .02). Among PWH, but not among participants without HIV, noncalcified aortic plaque volume related directly to aortic 99mTc-tilmanocept uptake at different uptake thresholds. An interaction (P = .001) was seen between HIV status and noncalcified plaque volume, but not calcified plaque (P = .83). Systemic levels of caspase-1 (P = .004), CD14\u2013CD16+ (nonclassical\/patrolling\/homing) monocytes (P = .0004) and CD8+ T cells (P = .005) related positively and CD4+\/CD8+ T-cell ratio (P = .02) inversely to aortic 99mTc-tilmanocept uptake volume.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Macrophage-specific arterial infiltration was higher among PWH and related to noncalcified aortic plaque volume only among PWH. Key systemic markers of immune activation relating to macrophage-specific arterial infiltration may contribute to heightened ASCVD risk among PWH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trials Registration<\/jats:title>\n                    <jats:p>NCT02542371.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiac301","type":"journal-article","created":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T08:58:19Z","timestamp":1658307499000},"page":"1823-1833","source":"Crossref","is-referenced-by-count":15,"title":["Increased Macrophage-Specific Arterial Infiltration Relates to Noncalcified Plaque and Systemic Immune Activation in People With Human Immunodeficiency Virus"],"prefix":"10.1093","volume":"226","author":[{"given":"Mabel","family":"Toribio","sequence":"first","affiliation":[{"name":"Metabolism Unit, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts 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,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeline","family":"Cetlin","sequence":"additional","affiliation":[{"name":"Metabolism Unit, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Wang","sequence":"additional","affiliation":[{"name":"Metabolism Unit, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iad","family":"Alhallak","sequence":"additional","affiliation":[{"name":"Metabolism Unit, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia G","family":"Durbin","sequence":"additional","affiliation":[{"name":"Metabolism Unit, Massachusetts General Hospital and Harvard Medical 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