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Management of recently acquired HIV infection has long been controversial, with the risks and benefits of treatment versus observation debated now for nearly 2 decades. On the risk side is the toxicity of lifelong treatment, especially because patients may have normal or near-normal CD4-cell counts after recovery from acute HIV infection and may remain asymptomatic for many years. Benefits include preservation of immunologic function, reduction in transmission risk to others, and perhaps reduction in the HIV reservoir. Now, findings from two new studies strongly suggest that we manage early HIV infection the same way we do long-established disease — with antiretroviral therapy (ART).
Le and colleagues conducted a prospective, observational s…