Timing of ART Initiation Affects Risk for AIDS-Defining and non–AIDS-Defining Cancer

Although guidelines currently recommend starting antiretroviral therapy (ART) as soon as possible after diagnosis of HIV infection, late diagnosis and, as a result, delays in treatment remain relatively common. As more persons with HIV develop non–AIDS-defining cancers, investigators analyzed data from 8318 persons in the D:A:D cohort to ask if delays in ART initiation increase this risk. They compared outcomes of immediate treatment (ART initiation within 6 months of HIV diagnosis regardless of CD4 count); ART within 6 months of a CD4 count <500 cells/µL; and ART within 6 months of a CD4 count <350 cells/µL.

During a median follow-up of 8.3 years (64,021 person-years), 231 diagnoses of non-AIDS–defining cancer and 272 diagnoses AIDS-definin…