Abstract: OBJECTIVE To explore the immunological efficacy of highly active antiretroviral therapy (HAART) for AIDS in 5 years so as to provide guidance for treatment of AIDS.METHODS A total of 145 patients who underwent regular follow-up treatment and received HAART in Guangxi Zhuang Autonomous Region Longtan Hospital for 5 years from Jan 2010 to May 2016 were enrolled in the study and were divided into the group A, B, and C according to the CD₄ cell counts; there were 29 patients with the CD₄ cell counts more than 200/μl in the group A, 31 patients with the CD cell counts ranged between 200 and 100/μl in the group B, and 85 patients with the CD₄ cell counts less than 100/μl in the group C.The CD₄ cell counts in different years were compared among the three groups of patients after the HAART; the constituent ratios of the patients with CD₄ cell counts more than 200/μl and the patients with CD₄ cell counts more than 500/μl were statistically analyzed.RESULTS The CD₄ cell counts of the three groups were significantly increased in different years after the treatment, compared with the baseline value(P＜0.05).There was no significant difference in the CD₄ cell counts between the group A and B in the third, fourth, and fifth year; the CD₄ cell counts were significantly increased year by year in the third, fourth, and fifth year(P＜0.05); the ascensional range of CD₄ cell counts was the greatest in the first year, which was 150/μl in group A,111/μl in group B, 157/μl in group C, significantly greater than that of the intra-group in other time periods (P＜0.05).During the five years, there were 29 patients of the group A whose CD₄ cell counts were continuously more than 200/μl, and the constituent ratios of the patients with the CD₄ cell counts more than 200/μl were increased year by year in the group B and C (P＜0.05); the constituent ratios of the patients with the CD₄ cell counts more than 500/μl were gradually increased in the three groups (P＜0.05).After the treatment for 5 years, the constituent ratio of the patients with the CD₄ cell counts more than 200/μl was 100.0% in group A, 93.55% in the group B, 83.53% in the group C; the constituent ratio of the patients with the CD₄ cell counts more than 500/μl was 65.52% in the group A, 32.26% in group B, 27.06% in the group C.CONCLUSIONThe CD₄ cell counts reach and maintain at far more above the baseline value after 5 years of HAART, however, some of the patients with the baseline CD₄ cell counts less than 200/μl still have adverse immune reconstitution, the CD₄ cell counts of most of the patients are difficult to recover to more than 500/μl, the CD₄ cell counts of more than half of the patients with the baseline CD₄ cell counts more than 200/μl recover to the normal level.The early start and long-term maintenance of antiviral therapy may achieve better immunological efficacy.