Evidence map›Paper›PMID 42251304›Full record

Trial reportBMC cancer2026

Early antiretroviral therapy and long-term cancer risk in HIV: 9-year outcomes from the START randomized trial.

Ramya Ramaswami, Jacqueline A Nordwall, Duncan Gilbert, Ellen Kitchell, Alisa Timiryasova, Ronald Mitsuyasu, Andrew N Phillips, Jens Lundgren, Sophie Grabar

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00867048 (Strategic Timing of AntiRetroviral Treatment), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00867048 phase4completednot on this map

Strategic Timing of AntiRetroviral Treatment

TypeinterventionalSponsorUniversity of MinnesotaRan2009 to 2022Enrolled4,688ConditionsHIV InfectionArmsAll licensed antiretroviral medications
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Ramya RamaswamiHIV and AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 10 Center Drive, 6N106, Bethesda, MD, 20892, USA. ramya.ramaswami@nih.gov.
Jacqueline A NordwallDivision of Biostatistics and Health Data Science, University of Minnesota, Minneapolis, MN, USA.
Duncan GilbertMRC Clinical Trials Unit at University College London, London, UK.
Ellen KitchellDivision of Infectious Diseases and Geographic Medicine, University of Texas Southwestern, Dallas, TX, USA.
Alisa TimiryasovaCHIP Centre of Excellence for Health, Immunity, and Infections, Department of Infectious Diseases, Rigshospitalet, and Department of Clinical Medicine, Copenhagen, Denmark.
Ronald MitsuyasuUniversity of California Los Angeles Clinical AIDS Research and Education Center, Los Angeles, CA, USA.
Andrew N PhillipsInstitute for Global Health, University College London, London, UK.
Jens LundgrenCHIP Centre of Excellence for Health, Immunity, and Infections, Department of Infectious Diseases, Rigshospitalet, and Department of Clinical Medicine, Copenhagen, Denmark.
Sophie GrabarSorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie Et de Santé Publique, AP-HP, Hôpital St Antoine, Paris, 75012, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntiretroviral therapy (ART) reduces cancer risk in people with HIV (PWH) but the long-term impact of immediate ART initiation on infection-related and infection-unrelated cancers remains unclear.

methodsIn the Strategic Timing of Antiretroviral Treatment (START) trial, 4684 ART-naïve adult PWH with CD4 + T-cell count above 500 cells/mm

resultsOver a median follow-up of 9 years, 120 participants were diagnosed with cancer. The overall hazard ratio (HR) for cancer risk in the immediate versus deferred arms was 0.50 (95% CI: 0.34 to 0.73; p < 0.001). Pre-2016, the HR (immediate vs. deferred) was 0.33 (95% CI: 0.19 to 0.60; P < 0.001), while post-2016, it was 0.69 (95% CI: 0.42 to 1.13; P = 0.14), and P = 0.062 for the difference. For infection-related cancers in pre-2016 the HR was 0.24 (95% CI: 0.11 to 0.55; P < 0.001) and post-2016, HR was 0.53 (95% CI: 0.23 to 1.18; P = 0.12) and P = 0.18 for the difference. For infection-unrelated cancers, there was no significant difference in HR between immediate and deferred arms in either time period.

conclusionImmediate ART initiation significantly reduces infection-related cancer risk in PWH that persists long-term. CLINICAL

trial registrationNCT00867048.

Indexed as

Anti-HIV AgentsHIV InfectionsNeoplasmsAdultCD4 Lymphocyte CountFemaleFollow-Up StudiesHumansIncidenceMaleMiddle AgedRisk FactorsAnti-HIV AgentsARTHIV-associated cancersInfection-related cancerKaposi sarcomaSTART

Identifiers

PMID42251304
PMCPMC13459324

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