The optimal time to start antiretroviral therapy in asymptomaticpatients has been one of the central controversies in the careof patients with the human immunodeficiency virus (HIV) sincethe introduction of the first antiretroviral agent, zidovudine,more than two decades ago.1 Since then, periods of enthusiasmfor aggressive early intervention2 have been followed by a morecautious approach.3 This slowly swinging pendulum has been pushedback and forth by the extraordinary benefits of antiretroviraltherapy on one side4 and emerging data on its adverse effectson the other.5
The absence of a controlled, prospective study comparing earlyand deferred . . . [Full Text of this Article]
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From the Division of Infectious Diseases and the Department of Medicine, Brigham and Women's Hospital and Harvard Medical School — both in Boston.
This article (10.1056/NEJMe0902713) was published at NEJM.org on April 1, 2009. It will appear in the April 30 issue of the Journal.
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