Systematic review and meta-analysis of respiratory virus infections in HIV-positive and HIV-negative patients.

BACKGROUND

Respiratory virus infections are a major cause of morbidity and mortality globally, particularly among people living with HIV.

OBJECTIVES

To evaluate the impact of respiratory virus infections on clinical outcomes in HIV-positive individuals compared with HIV-negative individuals.

STUDY

DESIGN

We conducted a systematic review and meta-analysis of 19 studies comparing HIV-positive and HIV-negative individuals infected with common respiratory viruses (excluding SARS-CoV-2).

RESULTS

HIV-positive individuals had significantly higher odds of in-hospital mortality, prolonged hospitalization, and antibiotic use at admission. No significant differences were observed in intensive care unit admission, initial hospitalization, mechanical ventilation, or oxygen therapy. The most severe outcomes were associated with adenovirus, respiratory syncytial virus, and influenza. The certainty of evidence was moderate but limited by study heterogeneity and risk of bias.

CONCLUSIONS

These findings underscore the need for improved diagnostic tools, infection control strategies, and tailored clinical management for HIV-positive populations. Further prospective, multicenter studies are essential to inform evidence-based guidelines in both high- and low-resource settings.