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Secondary analyses were performed incorporating uncertainty in the exact timing of seroconversion to allow more precise estimation of the benefit of very early treatment initiation. For other patient and drug characteristics, associations with recovery were statistically significant but small in magnitude. However, there is still a clinical motivation to develop a better understanding of factors that predict the characteristics of CD4 recovery, because for some patients viral suppression does not translate into full CD4 recovery Previous studies have been conducted with analyses conditional on a single CD4 count at treatment initiation ignoring any prior observations, which may be subject to biases linked to the inherent measurement error and the fact that the decision to initiate treatment may have been based on the observed value However, because investigating this issue requires observation of patients with well estimated date of seroconversion, there is a need for further evidence from large seroconverter cohorts.

Higher viral load VL prior to treatment also has been found to be associated with better recovery in CD4 counts from baseline 1 , 15 , However, we wished to investigate the extent to which this association may be due to the fact that, in people who have recently seroconverted, high VL is a marker for a patient being closer to their true date of seroconversion. We also present an analysis in which uncertainty in the exact date of seroconversion for each patient is taken into account, with the aim of evaluating the potential additional benefit conveyed by very early treatment initiation and the timescale within which this can be obtained.

These criteria resulted in a total of patients from 22 contributing cohorts. The analysis was conducted according to drug regimen at initiation of cART, without adjustment of treatment indicators at change to regimen. Analyses were first conducted without censoring due to virological failure. We carried out maximum likelihood estimation using the ADMB software

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