To the Editor Khambaty et al¹ conducted a prospective study on the association between major depressive disorder (MDD) and incident acute myocardial infarction (AMI) in 26 144 patients with human immunodeficiency virus (HIV) infection. The authors specified 490 AMI events during 5.8 years of follow-up, and the hazard ratio (95% CI) of MDD for incident AMI was 1.29 (1.04-1.60) after adjusting for cardiovascular disease risk factors and was 1.30 (1.05-1.62) after adjusting for HIV-specific factors. The authors concluded that an approximately 30% increase of incident AMI was observed in patients with HIV infection.¹ I have some concerns with their study.