While it is little surprise that starting ARV therapy as soon as possible is better than waiting in the setting of patients learning of their HIV status via preventable and understandably traumatic development of an acute OI, I'm not sure it's accurate to characterize this approach as "early" antiretroviral therapy.

The choice of title (and the press releases that have spun off from this paper's publication) seem to be trying to fan the flames of the renascent early treatment frenzy, and for this reason seems somewhat misleading.

I myself must also wonder about the PLoS Medical journals' team in regards to vetting self-reporting conflicts of interest. The lead author of this paper, as just one example, declares no competing interests and yet reports, in his capacity of HIV Advisory Board member of the pharma funded Clinical Care Options HIV med-ed and conference reporting site, serving as a paid consultant to 4 companies with HIV drugs as well as receiving "fees for non-CME services" from 2 others. He also reports receiving research monies from 5 pharma companies and 1 biotech. Until last year he also served on the speakers bureaus of BMS and Gilead Sciences.

The documentation for these facts can be easily accessed via the following links:

http://www.clinicaloption...

http://www.clinicaloption...

http://cme.medscape.com/v... (click on Speaker Disclosures to open new window)

As it took me all of 3 minutes for find this information, one must ask him or herself why the PLoS Medicine team did not go to the trouble to verify these claims.

M Barr
AIDS Transparency & Accountability Watch
New York, NY 10011