Recently, the approach to initial therapy in naive patients has profoundly changed. The trend in 2008 suggests that HAART be started earlier than previously held. HAART should also be considered in selected patients with a CD4(+) count falling in the range 350-400 cells/microliter and in all subjects with a TCD4 (+) lower than 350 cells/microliter. Initial HAART provides a sufficiently broad range of choices, undoubtedly destined to further improve in the near future. However, such a choice has to take into account the patient's specific requirements and clinical picture, including comorbidity, risk factors for cardiovascular metabolic complications, simplicity and convenience of therapeutic regimen, and long-term tolerability.