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

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The START trial compared cardiovascular disease (CVD) event rates between immediate and deferred antiretroviral therapy (ART) in HIV-infected individuals.
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Over a median follow-up of 9.3 years, CVD event rates were similar between immediate and deferred ART groups, with 71 total events recorded.
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A potential benefit of immediate ART was observed in female participants, but not in males, indicating a need for further evaluation.
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Traditional risk factors like hypertension and smoking were prevalent among participants, contributing to the increased CVD risk in people with HIV.
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The study highlights the complexity of balancing ART benefits against potential cardiovascular risks associated with certain antiretroviral medications.

Open Forum Infectious Diseases

by Nila J Dharan, Shweta Sharma, Alejandro Arenas-Pinto, Daniel Duprez, Vicente Estrada, Karen Ha, Mariana Angelica Kundro, Rosie Mngqibisa, Henry Mugerwa, David Munroe, Rakan Nasreddine, Tess E Peterson, Irini Sereti, Janine M Trevillyan, Jason V Baker, Gail V Matthews, Andrew N Phillips, for the INSIGHT START Study Group
September 15, 2025

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