This complex medical care consumed resources and enough time of trained health care workers highly, factors that may partly offset the price of starting antiretroviral therapy earlier. Our study was not blinded. This might not affect the primary study end point of survival, but we cannot exclude the chance that detection bias influenced the secondary end points. However, the rates at which participants remained in the study for follow-up assessments had been high, and the fact that the prices were similar in the two groups suggests that the strength of follow-up was related. To conclude, early antiretroviral therapy reduced the death rate by 75 percent in HIV-contaminated adults who had a CD4+ T-cell count that was higher than 200 and significantly less than 350 per cubic millimeter.