Early ART in the Setting of Acute OIs

When the results of ACTG A5164 came out — first at CROI 2008 and then in published form this summer (JW AIDS Clin Care Jun 22 2009) — we thought we could finally answer the question of when to start antiretroviral therapy (ART) in the setting of acute opportunistic infections (OIs). In short, it seemed treatment should be started sooner rather than later, to reduce the risk for HIV disease progression and death. Interim results from the SAPiT trial provided further support for this approach (JW AIDS Clin Care Mar 9 2009), showing a better chance of survival among patients who started ART within the first 8 weeks of tuberculosis (TB) treatment than among those who waited until after they had finished their TB treatment. Two other studies, ho…