Major treatment trial concludes time is of the essence

28 May 2015
Tablets in a hand

A large international trial has overwhelmingly concluded that the health of people living with HIV considerably benefits from starting treatment early. It is widely acknowledged that giving antiretrovirals (ARVs) to HIV positive people before their CD4 count – a measure of the immune system – drops too low, makes treatment more effective. This study provides crucial new evidence that could be a game-changer in the delivery of HIV treatment around the world.

In 2013, the World Health Organisation changed their recommendation for treatment to start at a CD4 count of 500 cells/mm3 (previously 350 cells/mm3). However, many countries have not yet changed their treatment policies. The Strategic Timing of Antiretroviral Treatment study (START) has revealed that the risk of an AIDS diagnosis, other serious illnesses or death is reduced by 53% when people start treatment at a CD4 count of 500 cells/mm3 or above. The message that timely treatment is effective could not be clearer.

The START study showed similar outcomes in both high- and low-income countries. We hope that this will influence the priorities of major funders of the HIV response, to enable low-income countries to meet the huge cost of reaching everyone who needs it with treatment. We now have clear evidence that early treatment is cost-effective; it saves lives, improves health and reduces new infections.


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