Although in basal ganglia both lower (Lu et al., 1996; Keller et al., 2004) and higher (Ashby et al., 2015) Cho/Cr and Cho have previously been found in HIV+ children, we found no difference in basal ganglia Cho between HIV+ children and controls at either age. In adults, elevated basal ganglia Cho/Cr normalizes after ART (Sailasuta et al., 2012). In these children, ART may have caused normalization of basal ganglia Cho levels, without preventing cell loss. However, the strongest neurometabolite effect observed in regressions with clinical data (B/SE, Table 4), is that of Cho at 7 years against CD4/CD8 at enrollment. This replicates the finding in the same cohort at age 5 (Mbugua et al., 2016), suggesting that better immune health in infancy may be associated with a greater cell density in childhood. Although the regression coefficient for Cho is 20 times smaller by 9 years of age, at 9 years the regression coefficient for Ins against baseline CD4/CD8 is similarly large.