Abstract: Objective To evaluate the effects of rapid initiation of antiretroviral therapy (ART) on virologicalsuppression and immune recovery in treatment-naive patients infected with human immunodeficiency virus type 1 (HIV-1) in Sichuan province. Methods A prospective study was conducted on treatment-naive HIV-1-infected patients whowere diagnosed and received first-time ART at Department of Infectious Disease, the Public Health Clinical Center ofChengdu, from March 2020 to May 2024. Participants were divided into two groups according to the time from diagnosisto ART initiation: a rapid initiation group (7 d afier diagnosis) and a control group (8-30 d after diagnosis). Theprimary outcome measures were virological suppression rate and immune recovery (changes in CD4 T lymphocytecount). Clinical outcomes were compared between the two groups at week 4, 24 and 48 of treatment. Results A total of306 patients were enrolled, including 134 in the rapid initiation group and 172 in the control group. In the rapid initiationgroup, the virological suppression rates at week 4, 24 and 48 were 64.7%, 87.9% and 89.7%, respectively. Comparedwith the control group, the rapid initiation group demonstrated significantly better virological suppression at all follow-uptime points (P<0.001). Regarding immune recovery, CD4 T lymphocyte counts in the rapid initiation group showed a sustained increase from a baseline of 239.5 cells/uL to 390 cells/L at week 48, along with a continuous improvement irthe CD4/CD8 ratio (P<0.001). No significant differences were observed in biochemical parameters between the twogroups, and no serious adverse events occurred. Conclusions Rapid initiation of ART significantly improves virologicalsuppression rates and accelerates early immune recovery in treatment-naive HIV-1-infected patients in Sichuan province.This strategy provides strong evidence for enhancing treatment outcomes of HIV-1 infection and reducing viraltransmission.