Abstract: Objective To explore the changes in natural CD4+ T cell count before antiretroviral treatment (ART) and related factors in newly reported HIV infected persons in 2011.Methods The analysis was conducted on the CD4+ T cell count before ART in newly reported HIV infected persons who had received at least two CD4+ T cell count tests in 2011.Difference between the first and the last CD4+ T cell count tests was calculated and described.Cox multivariate proportional hazards model was used to identify the factors associated with the obvious decline of CD4+ T cell count among them.Results A total of24 222 HIV infected persons were included in the study.The monthly change of CD4+ T cell count between the first and the last CD4+ T cell count tests had a median of-2.00 cell/l (IQR:-7.81-3.01).In the last CD4+ T cell count test,60.9% of the HIV infected persons had decreased CD4+ T cell count compared with the first one,and the decrease was more obviously when the interval between two tests was longer.Result from the Cox multivariate proportional hazards model analysis indicated that older age and HIV homosexual transmission were significantly associated with the significant decrease of CD4+ T cell count.Conclusion There was a progressive decline in the CD4+ T cell count in most newly HIV infection cases before ART.It is necessary to strengthen the follow up and CD4+ T cell count test and conduct early ART among them,especially among the elderly and those infected through homosexual contact.