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What Killed the START Patients on Immediate HIV Treatment? (Editor's Pick)

Aug 16, 2015

In the article: > The Day the HIV Treatment Pendulum Stopped Swinging > By Myles Helfand > From TheBodyPRO.com

It states:

> Twelve people died in the immediate-therapy arm; 21 people died in the deferred-therapy arm.

What killed the twelve people in the immediate-therapy arm?

Thank you!

Response from Dr. Young

Hello and thanks for posting your important question.

The START study showed that immediate (vs delayed) initiation of HIV treatment was associated with fewer serious medical complications (like cancer and TB) and death, while not associated with increased drug toxicity. Furthermore, the result was true for both rich- and poor countries.

In the report report appendix S3 is a full description of the types of complications and causes of death in the study (of the 4685 patients enrolled). Overall, there were nearly twice as many deaths among the group of people who waited to start treatment: 12 deaths in the immediate treatment group vs 21 in the delayed treatment group.

Of the 12 deaths in the immediate group, there were 3 from cardiovascular causes, 4 from accidents/violence, 2 from unknown causes and 1 from AIDS-related cause. In the delayed treatment group, the causes of death were: 1 each from AIDS-related, cardiovascular disease and cancer; 3 from accident/violence; 2 each from liver/kidney disease and suicide. There were no medication-related deaths.

Hope that's helpful, BY



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