TEMPRANO Better Than Tarde for ART Initiation

To define the roles of early antiretroviral therapy (ART), isoniazid preventive therapy (IPT), or both in a region with high tuberculosis (TB) burden, investigators conducted an unblinded multicenter superiority trial in the Ivory Coast among HIV-infected adults with CD4 counts <800 cells/mm³.

Participants were assigned to one of four groups: deferred ART (to be started when WHO CD4 criteria for ART initiation were met), deferred ART plus IPT (deferred ART; 6-month course of IPT initiated 1 month after study enrollment), early ART (immediate initiation), or early ART plus IPT. A total of 2056 patients (41% with baseline CD4 counts ≥500 cells/mm³) were included in the analysis. The primary endpoint was a composite of any-cause death, AIDS-def…