Patients receiving 24 weeks of early cART more often reported tingling in the hands or feet (P = 0.02) and a numb feeling in the fingers or toes (P = 0.01) than patients receiving 60 weeks of early cART or no treatment. Patients receiving no treatment more often reported itchiness (P = 0.001) and skin changes (P = 0.04)

than patients receiving 24 or 60 weeks of early cART. At week 8, patients receiving 24 or 60 weeks of early cART more often reported nausea (P = 0.002), diarrhoea (P < 0.001), abdominal pain (P = 0.02), stomach pain (P = 0.049) and dizziness (P = 0.01) than patients receiving no treatment (Fig. 2). These differences had disappeared at week 24. No differences in patient characteristics and HRQL at baseline RGFP966 in vivo Palbociclib and during follow-up were seen between the randomized (n = 16) and nonrandomized (n = 12) untreated patients, except that the randomized patients were more often born in the Netherlands [15 of 16 (94%) versus seven of 12 (58%); P = 0.02]. When we repeated the mixed linear models including only the RCT patients, the significant differences in HRQL among the three groups

disappeared for cognitive functioning and mental health, although the trend remained similar. The differences in pain, physical functioning, role functioning and the PHS score remained significant. For these scales, patients receiving 60 weeks of early cART had a significantly better HRQL than patients why receiving 24 weeks of early cART. The differences seen in reported symptoms remained the same. The present study was set up as a substudy of the Primo-SHM RCT, which demonstrated a clinical benefit of 24 and 60 weeks of cART initiated during PHI [1]. This substudy provides the first data on the effects on HRQL of temporary treatment during PHI. Early cART did not have a negative impact on patients’ HRQL over a study period of 96 weeks as compared with no treatment. Overall, patients receiving 60 weeks of cART showed a better HRQL than patients in whom treatment was deferred. Although the patients on early cART initially suffered more from physical symptoms,

which were probably related to drug toxicity, this seemed to have minor effects on their HRQL perception. This is in agreement with a previous study in which persons with chronic HIV infection on cART made distinctions between symptoms caused by HIV itself and those caused by drug toxicity when evaluating HRQL. Disease-related symptoms, but not side effects, were related to perceptions of general health [14]. Regardless of cART intervention, social functioning, health distress, overall quality of life, energy/fatigue and the MHS score improved significantly during the 96 weeks of follow-up in all groups. This might be explained by initial psychological distress as a consequence of being diagnosed with PHI and its acceptance over time. In addition, the symptoms occurring during PHI will also diminish without early treatment over time.