Sereti I, et al. - Given the established benefit of immediate antiretroviral therapy (ART) at CD4 >500 cells/μL in the Strategic Timing of Antiretroviral Treatment (START) study, researchers further assessed the benefits and risks of immediate ART in participants with low pretreatment viremia, including virologic suppressors. In this randomized prospective international study, they included START participants with enrollment viremia <3000 c/mL (N = 1134 including 93 with viremia ≤50 c/mL). Among these START participants, they noted higher CD4 counts, greater proportion with suppressed viremia, and decreases in D-dimer levels on immediate ART despite the lack of difference in serious clinical outcomes. Data thereby provide support for immediate ART in people with low viremia, although equipoise remains for suppressors.