In this study first-line antiretroviral treatment failure was found to be significantly associated with stage III and IV baseline WHO clinical stage of HIV, low baseline Body Mass Index (<18.5 kg/m2), baseline CD4 count <100cells/mm3, having history of TB co-infection, having history of lost to follow up, poor adherence to antiretroviral drugs and initiation of ART after two years of diagnosis with HIV positive. The gene discussed is CD4; the disease is coinfection.