Respiratory viral infection and HIV viral load and CD4+ cells count of HIV infected children attending selected clinics in Southwest, Nigeria

Abstract

Respiratory viral infections are a major cause of illness in children, especially those living with HIV. Co-infections may worsen immune suppression and accelerate HIV disease progression, yet data on their impact in pediatric populations remain limited. To assess the influence of HIV infection on the prevalence of respiratory viral infections and its association with HIV viral load and CD4 + cell counts in children attending clinics in Southwest Nigeria, a cross-sectional case-control study was conducted over 12 months involving 590 HIV-infected children and 590 HIV-uninfected controls, all presenting with respiratory symptoms. Respiratory viruses were detected using RT-PCR. HIV viral load and CD4 + cell counts were measured using standard protocols. Respiratory viruses were detected in 56.9% of HIV-infected children compared to 9.2% of HIV-uninfected controls (p < 0.001). HIV-infected children had significantly higher odds of infection with RSV (OR = 9.21; 95% CI: 6.19–13.7), influenza (OR = 28.7; 95% CI: 13.13–62.74), and parainfluenza virus (OR = 22.12; 95% CI: 10.04–48.73). Combined viral infections were also more prevalent (OR = 12.79; 95% CI: 9.22–17.75). High HIV viral load was strongly associated with increased odds of RSV (OR = 18.35), influenza (OR = 17.16), and parainfluenza (OR = 31.75) detection, with combined infections showing an OR of 19.86. HIV positive children with respiratory viral infections showed a significant decline in CD4 + cell counts (median = 1420 cells/mm3) compared to non-HIV infected children with respiratory infection (median = 2986 cells/mm3). There was a strong inverse correlation between HIV VL with CD4+ cell count (r = − 0.85; p = 0.005). Respiratory viral infections are associated with increased HIV viral load and reduced CD4 + cell counts in HIV-infected children. These findings highlight the need for integrated viral screening and management strategies in pediatric HIV care.