Similar to previous findings in children without HIVE, at age 7 we find no differences in NAA or other metabolites between HIV+ children and controls. Although NAA/Cr levels have been shown to be decreased in basal ganglia in children with HIVE (Pavlakis et al., 1995; Lu et al., 1996), in HIV+ children without encephalopathy NAA levels have been reported to remain unchanged (Keller et al., 2004). In our own previous study of the same cohort at age 5 years, children who initiated ART before 12 weeks had higher NAA and choline compared to the uninfected group of which 80% were HIV exposed (Mbugua et al., 2016). Notably, at age 9 we find lower NAA and Glu (but not NAA/Cr or Glu/Cr, Supplementary Table 2) in HIV+ children, even though only six children in our 9-year old HIV+ group had a prior HIVE diagnosis.