OBJECTIVES: To assess the clinical and economic burden of the human immunodeficiency virus (HIV) in the US veteran population. METHODS: A retrospective study including patients diagnosed with HIV between October 1, 2005 and September 30, 2010 was conducted using the Veterans Health Affairs Medical SAS Datasets. Health care resource utilization and costs were assessed in the 12-month follow-up period. Patients' demographic, clinical and discharge statuses were compared using Chi-square testing and standardized differences. Student t-tests were used for the means of continuous variables. Mortality and survival rates were calculated using the Kaplan and Meier method and the PROC LIFETEST procedure. RESULTS: Among all study patients diagnosed with HIV (n=29,388), mortality rates in the 12-month follow-up period were 15.79% (n=4,635), and 5.15% for patients under age 40, 16.25% for patients age 40 to 65, and 30.01% for patients age 65 and over. The most commonly prescribed medications were emtricitabine/tenofovir (2.39%), efavirenz (2.34%), sulfamethoxazole/trimethopri (1.88%), lamivudine/zidovudine (1.81%), lopinavir/ritonavir (1.76%), and atazanavir (1.68%). The most commonly performed laboratory tests were for sodium (3.38%), potassium (3.27%), creatinine (3.25%), chloride (3.25%), glucose quant (3.18%), and carbon dioxide content (2.94%). For patients with HIV, the average numbers of inpatient (0.48), emergency room (ER) (0.82), physician office (35.31) and outpatient visits (35.56) were calculated per patient, separately. The percentages of inpatient (24.62%), ER (35.01%), physician office (99.90%) and outpatient visits (99.93%) were also computed, which led to the following costs for inpatient ($7,828), ER ($329), physician office ($14,080) and outpatient visits ($14,450). CONCLUSIONS: This study found that emtricitabine/tenofovir and efavirenz are the most frequently prescribed drugs after diagnosis of HIV. More research, however, is required to better understand adverse events and side effects.