Benefits and risks of early antiretroviral therapy for HIV

Early antiretroviral therapy may offer benefits to people with HIV infection who do not have symptoms.1 You should not start antiretroviral therapy until you have considered the following benefits and risks and discussed all the issues with your health professional.

Type of therapy	Early therapy: Treatment with antiretroviral therapy before HIV-related symptoms develop	Delayed therapy: Treatment with antiretroviral therapy after HIV-related symptoms or AIDS develops
Benefits	Increased ability to achieve and maintain control of viral replication Delay or prevention of immune system compromise Slowed progression of HIV to AIDS Lower risk of drug resistance with complete viral suppression Possibly may decrease the risk of HIV transmission. Note: Even with early therapy, the risk of HIV transmission still exists; antiretroviral therapy cannot substitute for primary HIV prevention measures, such as use of condoms and safer sex practices.	Avoids negative effects on quality of life, such as inconvenient medication schedules Avoids serious medication-related problems Delays development of drug resistance Preserves the maximum number of available and future drug options when HIV disease risk is highest
Risks	Medication-related side effects that may cause a reduction in your quality of life Greater chance of serious medication-related problems Earlier development of drug resistance, if viral suppression is not complete Limitation of future antiretroviral treatment options Not all the risks of starting antiretroviral therapy before HIV-related symptoms develop are known.	Possible risk of permanent impaired immune system May have greater difficulty in suppressing viral replication Possibly may increase the risk of HIV transmission