Starting Antiretroviral Therapy Early Has Long-Term Benefits

Delayed initiation of antiretroviral therapy results in excess risk for AIDS and severe non-AIDS events despite achieving viral suppression.

In 2015, interim results of the START (NEJM JW Infect Dis Sep 2015 and N Engl J Med 2015; 373:795) and TEMPRANO studies (NEJM JW Infect Dis Sep 2015 and N Engl J Med 2015; 373:808) ended the debate about when to start antiretroviral therapy (ART) in persons with HIV, leading to the recommendation that ART should be initiated as soon as possible after HIV diagnosis. Thereafter, START participants in the deferred arm (who began ART once their CD4 count was <350 cells/mm³) were advised to initiate ART, and participants in both arms were followed until the end of 2021 for a composite outcome of serious AIDS or death, opportunistic infections, or a serious non-AIDS event. Now, the investigators ask whether the risks associated with deferring ART…

Reviewing Author

Carlos del Rio, MD

Disclosures

Grant/Research SupportNIH/National Institute of Allergy and Infectious Diseases; NIH/National Institute on Drug Abuse

Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes; Vaccines

Leadership Positions in Professional SocietiesInternational Antiviral Society–USA (Board of Directors); Infectious Diseases Society of America (Past President)

Carlos del Rio, MD

Disclosures

Grant/Research SupportNIH/National Institute of Allergy and Infectious Diseases; NIH/National Institute on Drug Abuse

Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes; Vaccines

Leadership Positions in Professional SocietiesInternational Antiviral Society–USA (Board of Directors); Infectious Diseases Society of America (Past President)

Starting Antiretroviral Therapy Early Has Long-Term Benefits

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Reviewing Author