Study	Method	Participants	Interventions	Outcomes	Setting	Disease severity	Overall risk of bias	Narrative of findings
ACTG‐A5164, 2009	RCT	282, AIDS‐related opportunist infections 10 people with histoplasmosis	Early ART (n 7) Deferred ART (n 3)	Primary: composite endpoint of death and HIV viral load. Safety: IRIS; lab adverse events Grades 2–4; clinical adverse events Grades 2‐4.	USA, South Africa	Baseline median CD4 count 29 (IQR 10–55) cells/μL	Low	1/7 participants with histoplasmosis dies in the early ART group. 0/3 participants with histoplasmosis died in the deferred ART group. 1/3 people with histoplasmosis in deferred ART arm developed histoplasma IRIS (day 47). IRIS aetiology: hepatitis C. Survived. 1/7 people with histoplasmosis in early ART arm developed hepatitis C IRIS (day 14). IRIS aetiology: histoplasmosis. Survived.
ART: antiretroviral therapy; IQR: interquartile range; IRIS: immune reconstitution inflammatory syndrome.