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    START (Strategic Timing of Antiretroviral Treatment)

    ​​​UPDATE 25 June 2015

    The early release of interim results from the START (Strategic Timing of Antiretroviral Treatment) study on 28 May 2015 provides important new evidence on when to start antiretroviral treatment.​

    The trial found a 53% reduction in the primary endpoint of AIDS, serious non-AIDS or death for those who started treatment immediately when their CD4+ T-cell count was above 500 cells/mm3 as compared to waiting until the CD4 T-cell count dropped below 350 cells/mm3  (HR 0.47; 95%CI 0.32 to 0.68). 

    Additionally, safety outcomes (e.g., serious adverse events and hospitalisations) were similar in the two arms of the study (the immediate vs deferred treatment groups).  In the interim, clinicians should consider the implications of the decision by START study investigators to release these results and their recommendation that all individuals in the deferred treatment arm be offered antiretroviral therapy.

    The full study results will be presented at the IAS conference in Vancouver in July and the clinical guidance on when to start antiretroviral therapy will be updated accordingly.

    Further details are available at:

    https://kirby.unsw.edu.au/content/start-hiv-treatment-study-q

    http://www.nih.gov/news/health/may2015/niaid-27.htm​


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