People Living With HIV (PLWH) are at an increased risk of developing diabetes and cardiovascular ischaemic events, which are key contributors to morbidity and mortality in this population. Ageing biomarkers and monocyte activation have emerged as important factors in the pathogenesis of these conditions in PLWH. This article explores the interplay between HIV infection, ageing biomarkers, monocyte activation, and the development of diabetes and cardiovascular ischaemic events. Understanding these mechanisms is crucial for identifying potential biomarkers, developing preventive strategies, and improving the management of these comorbidities in HIV-infected individuals [1,2].