Background: Highly active antiretroviral therapy (HAART), has significantly reduced thernmortality of HIV infected population but, the morbidity attributed to it remained a seriousrnconcern. The magnitude and factors associated with Immuno-virologic responses to HAART arernless investigated.rnObjective: To assess Immuno-virologic response and its association with inflammation, Clinicalrnand Socio-demographic factors after at least 12 months of HAART initiation among patientsrnattending Zewditu Memorial Hospital, Addis Ababa, EthiopiarnMethod: A hospital based prospective cross sectional as well as retrospective longitudinal studyrnwas conducted from January to June 2016 at Zewditu Memorial Hospital. Socio-demographicrnand clinical information was collected from ART database of 402 HIV patients who were onrnHAART for at least 12 months. Blood was collected from when participants come for theirrnscheduled second follow up visit since ART initiation and examined for CD4 count and, viralrnload. Serum sample was separated for C-reactive protein determination. Descriptive statisticsrnwas used to determine the socio demographic characteristics and response rates. Binary andrnmultiple logistic regressions were computed to assess associations between variables using SPSSrnversion 20. P value less than 0.05 was considered as statistically significant.rnResult: From the 402 participants 235(58.5%) were females. Majority 174(43.8) were in the agerngroup of 30-39 years, attained high school 184(45.9%) and were married 193(48.0%). Mostrnparticipants 159(39.6%) were on 1e regimen (TDF+3TC+EFV) and have normal BMIrn224(55.7%). About 99.5% of them were on OI drugs. Concordance response was noted inrn311(77.4%) participants while 16 (4.0%) failed both immunologically and virologically. Despiternvirological response, 55(13.7%) participants failed to restore CD4 count of at least 50 cells/ mm3rnafter 12 months of HAART. Majority of CRP positive participants were in the unfavorablernresponder category. Participants having CD4>350 cells/ mm3 (adjusted odds ratio = 0.06; 95%rnCI: 0.02-0.19) and viral load < 1000 copies/ml (adjusted odds ratio = 0.26; 95% CI: 0.13-0.55) atrnbaseline were significantly associated factors of immuno-virological discordant responsesrnConclusion: Individuals who had a baseline CD4 count above 350 cells/ mm3 and baseline viralrnload below 1000 copies/ml were less likely to have discordant response. Though the concordancernresponse rate is high (77.4%), the proportion of patients failing immunologically (13.7%) despiternvirologic response, signifies the importance of virologic monitoring of HAART responses.rnSimple markers like CRP could supplement monitoring of unfavorable responses.rnKeywords: HIV, CD4, Viral-load, CRP, Concordant response, Discordant response