It is a challenge for clinicians to manage patients with human immunodeficiency virus (HIV) drug resistance. Here we reported the successful antiretroviral therapy in a case with complicated recombinant HIV-1 subtype and multidrug-resistant. The drug adherence played an important role in the case. The difference between results HIV drug resistance test and in vivo effect of drugs should be taken into account. The viral response to drugs and viral escape mechanism in rare HIV subtypes need further research .