Timing of Initiation of First-line Antiretroviral Therapy

  • Authors: Marshall J. Glesby, MD, PhD; Timothy J. Wilkin, MD, MPH (More Info)
  • Section Editor: Joel E. Gallant, MD, MPH
  • Editors in Chief: Daniel R. Kuritzkes, MD; Joseph J. Eron, Jr., MD
  • Last Reviewed: 4/1/16 (What's New)


  • Data suggest that uncontrolled HIV replication and advanced HIV disease may contribute to atherosclerosis
    • In the SMART study, there were more coronary heart disease events in patients receiving intermittent ART vs patients receiving continuous therapy[SMART 2006]
    • Potential mechanisms include increased inflammation or worsened lipid profile during treatment interruption[Phillips 2008; Kuller 2008]

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