Objective To investigate the problem of adverse effects in common AIDS patients and AIDS patients with tuberculosis after highly active antiretroviral therapy (HAART). Methods The case group was composed of 106 patients with both AIDS and tuberculosis. The control group was composed of 134 common AIDS patients. The rates of adverse effects and the increase of CD4 + T cell count in those groups after first year HAART were observed and compared. Results The rates of adverse effects in the case group was 36. 8% ,which was more than that in the control group (26. 9%), but the difference was not significantly different(x2 =2.715, P =0. 099). The count of CD4+ T cell in most of the patients was increased after HAART (P ＜ 0. 01). The increase of CD4 + T cell count in the case group [(147.2 ±137.6)/μl] was higher that in the control group[(142. 1 ± 127. 0)/μl after six months HAART vs. (166. 5±133. 1)/μl in case group], and it was lower than that in control group after nine months HAART [(172.7±107.5)/μl], however the difference was not significant(P ＞0.05). Conclusions HAARTcould reconstruct the immunition of AIDS patients. The increase of CD4 + T cell count did not show significant difference between common AIDS patients and AIDS patients with tuberculosis after HAART. AIDS patients with tuberculosis might not increase the risk of development of adverse effects during HAART.