On September 30, 2015, the World Health Organization updated its guidelines for HIV anti-disease treatment, suggesting that antiviral treatment is needed regardless of CD4 level as long as one is HIV-positive, i.e. Treat all. the strategy of treating all HIV-positive infected people is not a new thing, the US recommended so back in February 2012, but at that time the Americans advocated treating CD4 above 500 But at that time, Americans advocated treating people with CD4 above 500 mainly to reduce infectiousness, and only moderately recommended based on expert opinion. It was not until July of this year, when the results of two key studies on when to start antiviral treatment, the START study and the TEMPRANO study, were published, that the U.S. strongly recommended antiviral treatment for all infected individuals. These two studies were randomized controlled studies comparing the impact on morbidity and mortality of starting antiviral treatment with CD4 above 500 versus starting treatment with CD4 down to much lower (below 350), which is compelling. Treating all infected people is an ambitious program. UNAIDS estimates that with good implementation this policy could reduce AIDS-related deaths by 2.1 million and new HIV infections by 2.8 million by 2030. Treating all infected people is also a wonderful vision. In the real world, it can be difficult to operationalize. More human and material resources are needed. HIV treatment is different from most diseases in that it is lifelong treatment and long-term management is a huge challenge. Treating all infected individuals may still be viewed differently by different clinicians. And, while there may be good reasons from a population perspective, what about the specific individual patient? Is it really necessary to start antiviral therapy when a young person without any comorbidities has a CD4 above 500 (e.g., 700 or 800 or 800 or 900), if not solely to reduce infectivity? Moreover, the START study compared starting treatment with CD4 above 500 to starting treatment with CD4 below 350, so what about CD4 between 350 and 500? Is there a difference between patients who started treatment with CD4 above 500 and those who started treatment with CD4 above 500? We do not know.