Early versus deferred antiretroviral therapy initiation and long-term cardiovascular disease outcomes in people with HIV: The START study.

ABSTRACT:

Background

It is unknown whether delayed antiretroviral therapy (ART) initiation worsens CVD outcomes in people with HIV (PHIV). This study compared CVD event rates between PHIV who were randomized to receive immediate versus deferred ART.

Methods

ART-naïve adult PHIV with CD4+ counts > 500 cells/µL were randomized to immediate versus deferred ART initiation. Event rates for the main composite CVD outcome (myocardial infarction, coronary artery disease requiring revascularization, stroke and CVD-related death) were estimated for: (i) pre-2016 (treatment arms as designed); (ii) post-1Jan2016 (ART use similar across arms); and (iii) entire study follow-up period. Subgroup analyses were performed according to baseline characteristics.

Results

Among 4684 participants (med

SUBMITTER: Dharan NJ 

PROVIDER: S-EPMC12461870 | biostudies-literature | 2025 Sep

REPOSITORIES: biostudies-literature