Objective To analyze changes in hematological erythrocyte lineage in patients with HIV/AIDS and Mycobacterium tuberculosis infection (HIV/AIDS-TB) during intensive period of antiretroviral therapy (ART) and different ART regimens combined with anti-tuberculosis drugs. Methods Patients who were confirmed with HIV/AIDS-TB in an infectious disease hospital from 2014 to 2017 were selected and divided into three groups:group A received combination therapy of anti-tuberculosis drugs on the basis of ART, group B started ART within 8 weeks of anti-tuberculosis drug therapy, group C started ART after 8 weeks of anti-tuberculosis drug therapy; changes in parameters of erythrocyte lineage, such as red blood cell(RBC), hemoglobin(HGB), mean corpuscular volume(MCV), and RBC distribution width (RDW-CV) before therapy(baseline, at 0 week) and 1, 2, 4, and 8 weeks after therapy were detected and compared. Results A total of 180 patients with HIV/AIDS-TB were enrolled, group A, B, and C were 71, 75, and 34 cases respectively; 85.00% (n=153) of patients developed mild anemia, 84.51% (60/71), 85.33% (64/75), and 85.29% (29/34) were in group A, B, and C respectively. After anti-tuberculosis drug therapy, changes in absolute value of RBC in group A, B, and C had no significant difference (all P>0.05); after 4 weeks of therapy, increase of HGB in patients in group B was higher than baseline (P<0.05); MCV and RDW-CV in group A, B, and C after therapy were all higher than baseline (all P<0.05), but RDW-CV in group C recovered to baseline level at 8 weeks of therapy. HGB of group A and B at 4 weeks of TDF/3TC/EFV regimen combined anti-tuberculosis drug therapy were both higher than that of baseline (both P<0.05), but there was no significant difference in other regimens (all P>0.05). Conclusion Patients with HIV/AIDS-TB should start ART as soon as possible after anti-tuberculosis drug therapy, preferably within 8 weeks, changes in erythrocyte parameters in patients treated with different ART regimens combined with anti-tuberculosis therapy are different, effect of TDF therapy is ideal.