CD4 and mitochondrial DNA depletion syndrome 4a: We observed that after the WHO recommendation to initiate ART among people with CD4 <500 cells/μl and prioritize ART initiation in those with more advanced disease in 2013, the mean time without ART was reduced both among AHD and non-AHD, the mean time receiving ART and staying virally suppressed was lengthened in both groups, and the difference between groups observed for this stage was reduced.