Acute complications of atherosclerosis, such as acute myocardial infarction (AMI) are becoming more common in patients with HIV. But the risk of coronary heart disease in HIV patients is influenced both from traditional risk factors and from specific features of this disease. The aim of the present study was to examine in-hospital case fatality in HIV-infected patients with AMI.From the French nationwide hospital medical information database, data for all the consecutive patients hospitalized in the 1546 French hospital/clinics for AMI from 1 st January 2005 to 31 st December 2009 were analysed. Patients were match accordingfollowing parameters: age, gender, type of infarction (ratio 1:2).Among the 677 076 patients included, HIV-infected patients (n=1344) accounted for 0.20%. HIV patients were younger, more frequently male and more likely to smoke. Hospital mortality was 4.3% in the HIV-infected group compared with 7.0% in uninfected patients (p <0.0001), but no difference appeared between the 2 groups after matching (3.4% vs. 4.3%; p=0.1334). Based on a Cox regression model, HIV-infection was not an independent predictor of in-hospital mortality in the overall population or after matching. Among none HIV infected patients, dyslipidemia, current smoker, STEMI and coronary angioplasty were independent predictors of in-hospital mortality. In contrast, among HIV infected patients, dyslipidemia [OR-95%IC: 0.356 (0.141–0.903)], renal failure [OR-95%IC: 2.433 (1.174–5.044)] and STEMI [OR-95%IC: 2.130 (1.113–4.076)] were independent factors were associated with in-hospital mortality.HIV-infected patients have a greater risk of myocardial infarction, but the present study demonstrated than the short-term are similar to non infected patients. Moreover, chronic kidney disease is more common in HIV-infected patients and associated with a worse prognosis. Consequently HIV care increasingly needs to incorporate strategies to manage these non-infectious co-morbidity in primary and secondary prevention.