Résumé : Objective: We compared aortic stiffness between HIV-infected and HIV-uninfected individuals and examined the determinants of vascular aging during HIV infection. Methods: Aortic stiffness using carotid-femoral pulse wave velocity (cf-PWV) was evaluated cross-sectionally between HIV-infected individuals and uninfected controls frequency-matched for age and sex, and longitudinally in a subgroup of HIV-infected individuals. Determinants of elevated cf-PWV levels were assessed using logistic regression. Changes in cf-PWV levels during follow-up (mixed-effect linear regression) and risk factors for achieving cf-PWV below (Group 1) or above the median (Group 2) at last follow-up visit were evaluated only in HIV-infected individuals. Results: A total of 133 HIV-infected and 135 HIV-uninfected individuals (mean age: 47.7±8.9 years, 91% men) were enrolled. Median cf-PWV at baseline was similar between HIV-infected individuals and controls [7.5m/s (interquartile range=6.7-8.4) vs. 7.5m/s (interquartile range=6.6-8.4), respectively; P=0.64]. In multivariable analysis, only mean arterial pressure showed significant association with elevated cf-PWV in the overall population (P=0.036). In HIV-infected individuals, elevated cf-PWV was associated with current smoking (P=0.042), and nadir CD4 + T-cell count less than 200 cells/μl (P=0.048). Ninety-one HIV-infected individuals were followed for a mean 7.6±2.0 years. cf-PWV progression was associated with age (P=0.018), mean arterial pressure (P=0.020), and nadir CD4 + T-cell count (P=0.005). Patients from Group 2 had higher baseline waist circumference, pulse pressure, and nadir CD4 + T-cell count less than 200 cells/μl. Conclusion: We observed no difference in aortic stiffness between HIV-infected and controls. Moreover, aortic stiffness aging was independently associated with past severe immunodeficiency, along with other traditional risk factors. Our results call for early antiretroviral initiation.