Same-Day ART Start for HIV

Antiretroviral therapy (ART) for people with newly diagnosed HIV infection is often delayed until lab test results are available and extensive counseling has been provided. Now that there is definitive evidence that early initiation of ART saves lives (NEJM JW Infect Dis Aug 2015 and N Engl J Med 2015; 373:795), there is a push to start ART sooner. To investigate whether same-day HIV testing and ART initiation improves outcomes, investigators conducted a trial in Haiti.

They randomized 762 patients with newly diagnosed HIV, CD4 counts <500 cells/mm³, and a survey response indicating readiness to start ART to initiate TDF/FTC/EFV on the day of diagnosis or on day 21 (standard care). Patients had multiple counseling visits: same-day patients h…