Twenty-three Chinese men with primary HIV infection (PHI) who have sex with men, and 17 asymptomatic HIV-infected patients participated in this study. The effect of different initial activation parameters on viral set points and the immunologic progression of subjects with PHI were determined. We found that the proportions of CD38+DR+ and CD38-DR+ T cells were lower while those of CD38+DR- and CD38-DR- T cells were higher in patients with PHI than in the asymptomatic HIV-infected patients. The initial proportion of CD4+CD38+DR+ T cells emerged as a statistically significant predictor (P < 0.05) of viral set points by multivariate least squares regression. In addition, individuals with a higher initial proportion of CD4+CD38+DR+ cells were more likely to have CD4+ T cell counts decrease to ≤ 350 cells/µl (P = 0.015), as determined by Kaplan-Meier curve analysis. We concluded that the initial CD4+CD38+DR+ T cell level in PHI patients is an important prognostic parameter of viral set points and is therefore related to disease progression.