With proper treatment, HIV is a manageable disease. But for the best outcomes from head to toe, recent study findings show that therapy with antiretroviral medications must be started early to halt the progressive damage to the brain that the virus can cause.

For the study, two international research teams reviewed magnetic resonance imaging (MRI) data from 65 patients at the University of California at San Francisco who contracted HIV within the previous year.

Scientists compared their MRI information to that of 19 participants without the virus and 16 patients living with HIV for at least three years. The researchers found that the longer individuals went without treatment, the more loss of tissue volume and thinning of the brain’s cortex they experienced, which placed cognitive functions such as perception, language, memory and consciousness at risk.

Once people began treatment, however, these changes stopped and thickness increased slightly in the organ’s frontal and temporal lobes.

“The findings make the neurological case for early treatment initiation and send a hopeful message to people living with HIV that starting and adhering to cART [combined antiretroviral treatment] may protect the brain from further injury,” says Ryan Sanford, a PhD candidate at McGill University in Montreal and the study’s first author.