{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:17:58Z","timestamp":1758845878599,"version":"3.44.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003323","name":"Agence Nationale de Recherches sur le SIDA et les Hpatites Virales","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003323","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001321","name":"National Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001321","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Bundes ministerium fr Bildung und Forschung"},{"name":"European AIDS Treatment Network, Medical Research Council"},{"name":"National Institute for Health Research, National Health Service"},{"DOI":"10.13039\/100007249","name":"University of Minnesota","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007249","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100019211","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019211","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008021","name":"Bristol-Myers Squibb","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008021","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100019720","name":"GlaxoSmithKline","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019720","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010877","name":"ViiV Healthcare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010877","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>It is unknown whether delayed antiretroviral therapy (ART) initiation worsens CVD outcomes in people with HIV (PHIV). This study compared CVD event rates between PHIV who were randomized to receive immediate versus deferred ART.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>ART-na\u00efve adult PHIV with CD4+ counts &amp;gt; 500 cells\/\u00b5L were randomized to immediate versus deferred ART initiation. Event rates for the main composite CVD outcome (myocardial infarction, coronary artery disease requiring revascularization, stroke and CVD-related death) were estimated for: (i) pre-2016 (treatment arms as designed); (ii) post-1Jan2016 (ART use similar across arms); and (iii) entire study follow-up period. Subgroup analyses were performed according to baseline characteristics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 4684 participants (median age 36 years, 27% female, 30% Black race), 32% were smokers and 17% had a BMI \u2265 30\u2005kg\/m2. Comorbidities included hypertension (19%), dyslipidemia (8%), diabetes (3%); 0.8% had a history of CVD. The median time to ART initiation was 2.5 years (interquartile range [IQR] 1.6\u20133.5 years) in the deferred arm and 7 days (IQR 2\u201317 days) in the immediate arm. Over the entire study follow-up period (median follow-up of 9.3 years), 71 participants (35 immediate, 36 deferred) experienced a CVD event with no difference in CVD event rates between the immediate and deferred arms (0.17 vs 0.17 per 100 person-years, respectively); these findings were consistent across the pre-2016 and post-1Jan2016 periods. There were 58 CVD events among males (33 immediate; 25 deferred) and 13 among females (2 immediate; 11 deferred). A possible benefit of immediate ART was seen in females but not males (Hazard Ratio = 0.19 [95% confidence interval: 0.04\u20130.86] vs 1.33 [0.79\u20132.24]; interaction P-value = .014), though numbers of events were low.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Early versus deferred ART initiation was not associated with reduced CVD events. The potential benefit associated with immediate ART in female participants warrants further evaluation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaf561","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T20:02:29Z","timestamp":1758312149000},"source":"Crossref","is-referenced-by-count":0,"title":["Early versus deferred antiretroviral therapy initiation and long-term cardiovascular disease outcomes in people with HIV: The START study"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1175-5962","authenticated-orcid":false,"given":"Nila J","family":"Dharan","sequence":"first","affiliation":[{"name":"Therapeutic and Vaccine Research Program, Kirby Institute, UNSW Sydney , Sydney, New South Wales ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shweta","family":"Sharma","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Health Data 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