CD4 and AIDS: Another shift in HIV practice has been the immediate rather than deferred initiation of ART after diagnosis based on studies such as Strategic Timing of Antiretroviral Treatment (START) (nadir CD4>600 cells/μL), which showed reduced serious AIDS and non-AIDS events in those treated early.321 In contrast, the SMART study (nadir CD4 <250 cells/μL) found a 70% decrease in the risk of cardiovascular events in those randomized to early rather than deferred or interrupted ART.322 This increased risk correlated with increased proinflammatory markers in the deferred or interrupted group.4