Abstract:OBJECTIVE To understand occurrence and related factors of headaches in HIV infected patients before and after antiretroviral therapy (ART) in Taizhou prefecture, Zhejiang Province. METHODS HIV patients who started ART during January 2009-July, 2016 and met the inclusion criteria were included in the analysis. Logistic regression models were used to explore the potential risk factors. RESULTS A total of 2020 HIV-infected patients were included. Of them, 252 (12.5%) had headaches before ART which was significantly associated with older age, opportunistic infection and lower CD4 cell count. The majority (65.5%, or 165/252) of them had headaches relieved after ART. For those 1768 who did not have headaches before ART, 89 (5.0%) had at least a headache within 6 months after ART. Multiple logistic regression analysis indicated that opportunistic infections at baseline, older age, and EFV use were significantly associated with the new occurrence of headache after ART. CONCLUSION A pre-ART headache is mainly related to HIV disease progression and is mostly alleviated by ART. Newly occurred headaches after ART is associated with EFV use and immune reconstitution, suggesting potential benefits of early initiation of ART and appropriate use of antiretroviral drugs to headache remission.