The search for predictors of the progression of HIV infection to the clinical stage IV in patients before prescription and on antiretroviral therapy (ART) is an urgent scientific and practical task. The study aimed to identify predictors of the progression of HIV infection to the clinical stage IV in patients before prescribing and on the background ART based on the determination of clinical and genetic markers. A retrospective cohort study of 181 HIV-infected patients was conducted. For statistical data processing, regression analysis was used. Independent predictors of the progression of HIV infection to clinical stage IV in HIV-infected patients prior to ART were: male (p = 0,037), parenteral HIV transmission (p = 0,004), conclusion experience (p = 0,020), body mass index (BMI) less than 18.5 kg / m2 (p = 0,040), initial viral load (HV) of HIV> 1.0 x 105 copies / ml (p = 0,034), initial level of CD4 + T-lymphocytes <350 cells / μl (p = 0,000), hemoglobin level below 100 g/l (p = 0,001), the presence of which increases the risk of HIV progression to the clinical stage IV prior to prescribing ART. Independent predictors of the progression of HIV infection to the clinical stage IV in HIV-infected patients receiving ART were: parenteral transmission of HIV infection (p = 0,053), previous incarceration (p = 0,043), low adherence to ART (p = 0,028) , the initial level of CD4 + T-lymphocytes <350 cells/μl (p = 0,020), hemoglobin level below 100 g/l (p = 0,015) and carriage of the 299 Gly allele of the TLR4 gene (p = 0,016).