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Experts continue to debate the optimal time to initiate combined antiretroviral therapy in asymptomatic HIV-positive patients. Benefits of early treatment include preventing inflammation, preserving immune function, and lowering HIV transmission; risks include drug resistance and toxicity. To identify the optimal time to initiate treatment, researchers used data from 12 prospective European and American cohort studies with a total enrollment of about 8400 patients (CD4 counts, 0.200×109–0.499×109 cells/L) who were antiretroviral therapy–naive and did not have histories of AIDS-defining illnesses.
During a median of 12 months, 460 participants developed AIDS-defining illnesses or died. All-cause mortality was similar for those who initiated t…