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目的:观察基线HIV-1 RNA > 50万copies/mL的HIV-1感染者，在高效抗反转录病毒治疗（highly active antiretroviral therapy，HAART）前后外周血totalHIV-1 DNA的变化。方法:从国家十二五科技重大专项课题中选取基线HIV-1 RNA > 50万copies/mL且HAART 96周HIV-1 RNA 500 000 copies/mL at baseline were recruited as the study group and HIV-1 HAART-naive patients with matched age and gender, and HIV-1 RNA < 500 000 copies/mL at baseline were selected as controls. Total HIV-1 DNA was quantified with peripheral blood at 0, 24, 48 and 96 weeks after HAART.n Results:Compared with the controls, total HIV-1 DNA levels at the baseline and 96 weeks after HAART in the study group were higher, namely, 3.48 (3.21-3.80) lg copies/10n 6 PBMCs vs 2.90 (2.54-3.30) lg copies/10n 6 PBMCs (n P<0.001), and 2.82 (2.38-2.96) lg copies/10n 6 PBMCs vs 2.37 (1.99-2.65) lg copies/10n 6 PBMCs (n P=0.001), respectively. Moreover, the detal HIV-1 DNA levels at 24 and 48 weeks after HAART in the study group were higher, namely, 0.67 (0.41-1.03) lg copies/10n 6 PBMCs vs 0.39 (0.09-0.73) lg copies/10n 6 PBMCs (n P<0.001), 0.8 (0.46-1.16) lg copies/10n 6 PBMCs vs 0.43 (0.04-0.63) lg copies/10n 6 PBMCs (n P<0.001), respectively. Both the levels of total HIV-1 DNA at baseline and after HAART were positively correlated to the baseline viral loads.n Conclusions:HIV-1 infected patients with very high baseline HIV-1 RNA levels presented higher total HIV-1 DNA level within 96 weeks after HAART. More potent initial HAART regimens should be considered to decrease total HIV-1 DNA.