The START study had 2 groups: 1. start HIV treatment as soon as possible, also known as the “immediate” group, and 2. start HIV treatment when the CD4 drops to below 350 cells/ml3, also known as the “deferred” group. The study followed according to the 2009 HIV treatment guidelines. During the course of the study, there have been changes in the HIV treatment guidelines but this did not affect the study design. The study continued to gather information. Its main interests (primary endpoints) are when the serious AIDS-related events occurred (i.e., deaths from AIDS, any AIDS defining event, Hodgkin’s lymphoma, etc) and when the serious non-AIDS-related events occurred (i.e., heart attack, stroke, heart disease, end-stage renal disease (start dialysis or renal transplantation), deaths from liver disease, deaths from renal disease, deaths from non-AIDS defining cancers, deaths from cancer, and any other deaths not due to AIDS). The other outcomes (secondary endpoints) the investigators were interested in were when the following events occurred such as serious AIDS-related events, serious non-AIDS related events, death from any causes, grade 4 events (i.e., any life-threatening symptoms not due to AIDS but require medical attention), unscheduled hospitalization not due to AIDS. The results from this article strongly confirms that there are considerable benefits to start HIV treatment as soon as possible regardless of CD4 level.
