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Therapeutics/Prevention
Randomised controlled trial
Initiating antiretroviral therapy in HIV-infected patients with >500 CD4 cells/µL provides more benefit than delaying treatment
  1. George W Rutherford1,2,
  2. Andrew Anglemyer3
  1. 1Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA;
  2. 2Department of Global Health Sciences, University of California, San Francisco, San Francisco, California, USA;
  3. 3Department of Health, Human Services and Public Policy, California State University Monterey Bay, Seaside, California, USA
  1. Correspondence to : Professor George W Rutherford, Department of Global Health Sciences, University of California, San Francisco, Mission Hall, 550 16th Street, P.O. Box 1224, San Francisco, CA 94143-1224, USA; george.rutherford{at}ucsf.edu

https://doi.org/10.1136/ebmed-2015-110307

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    Commentary on: The INSIGHT START Study Group. Initiation of Antiretroviral Therapy in Early Asymptomatic HIV Infection. N Engl J Med 2015;373:795–807.OpenUrlCrossRefPubMed

    Context

    It is clear that the successful treatment of HIV infection requires that patients be diagnosed, be engaged in regular care and receive and adhere to effective antiretroviral therapy (ART). When to start ART has been less clear. WHO guidelines have evolved over time from reserving therapy for the most immunocompromised in September 2015 treating all patients with HIV infection.1 Two large well-conducted randomised controlled trials (RCTs), the Strategic Timing of Antiretroviral Therapy (START) trial2 and the TEMPRANO ANRS 12136,3 have been particularly important in advancing the evidence base for universal therapy.

    Methods

    START was designed and conducted by the International Network for Strategic Initiatives …

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    Footnotes

    • Contributors GWR wrote the manuscript. AA contributed to the analysis, reviewed and approved the manuscript.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.