Initiation of ART should be deferred until AKI has resolved with creatinine clearly on a downward trend and an eGFR suitable for the selected ART.42 Should a patient have AIDS, CD4 count < 50 cells/μL or severe HIV-related disease such as thrombotic thrombocytopaenic purpura, initiation of ART may be the overriding therapeutic goal even if AKI has not yet resolved. Here, CD4 is linked to acute kidney injury.